Article type
Year
Abstract
Introduction/Objective: Systematic review of data from RCTs of cognitive and behavioural treatments used in chronic pain management.
Methods: Thirty controlled trials of cognitive and/or behavioural treatments for chronic pain (including 2 osteoarthritis and 4 rheumatoid arthritis) were found through searches of Medline, Psychlit and Social Science Index. Details of the source of the study, study design, treatment content, participants and outcomes, were coded independently by three raters and a final value for each item reached by consensus. Coder agreement and measure reliability will be reported in addition to a bare bones meta-analysis of outcome effect sizes.
Results: Trials of active treatment or treatments were compared with waiting list control with no treatment (21), treatment as usual or education (14), or attention control (4). Three studies used pseudo-randomisation, and 4 have been unable to provide data to compute effect sizes. Mean outpatient treatment length was 15 hours (range 6-42 hours) and the length of follow-up was one year (s.d. 6 months). Studies showed considerable variation in content of treatment, experience of therapists, and domains of outcome measures; all lacked some detail necessary for appreciation of the methods and results. There was a median of 8 outcome measures per study. These data will be analysed for (1) overall effect size per study, and (2) variations in effect sizes attributable to the domain of measurement. Variations between treatment types are also analysed.
Discussion: In addition to estimating effects of psychological treatments for chronic pain, we recommend a set of minimal reporting standards and a set of common measures for psychological trials in pain be considered.
Methods: Thirty controlled trials of cognitive and/or behavioural treatments for chronic pain (including 2 osteoarthritis and 4 rheumatoid arthritis) were found through searches of Medline, Psychlit and Social Science Index. Details of the source of the study, study design, treatment content, participants and outcomes, were coded independently by three raters and a final value for each item reached by consensus. Coder agreement and measure reliability will be reported in addition to a bare bones meta-analysis of outcome effect sizes.
Results: Trials of active treatment or treatments were compared with waiting list control with no treatment (21), treatment as usual or education (14), or attention control (4). Three studies used pseudo-randomisation, and 4 have been unable to provide data to compute effect sizes. Mean outpatient treatment length was 15 hours (range 6-42 hours) and the length of follow-up was one year (s.d. 6 months). Studies showed considerable variation in content of treatment, experience of therapists, and domains of outcome measures; all lacked some detail necessary for appreciation of the methods and results. There was a median of 8 outcome measures per study. These data will be analysed for (1) overall effect size per study, and (2) variations in effect sizes attributable to the domain of measurement. Variations between treatment types are also analysed.
Discussion: In addition to estimating effects of psychological treatments for chronic pain, we recommend a set of minimal reporting standards and a set of common measures for psychological trials in pain be considered.