Are psychological interventions associated with chronic pain outcomes?

Bottom Line: Psychological interventions to treat chronic pain in older adults were associated with some small benefits.

Why The Research Is Interesting: Chronic pain not caused by cancer is a common condition in older adults and its management is complicated by a number of factors, including age-related physiologic changes and coexisting conditions. An ongoing opioid crisis means there is increased attention on nonpharmacologic therapies for chronic pain that use cognitive behavioral therapy approaches.

Who and When: 22 studies with 2,608 participants; included studies used a randomized trial design and evaluated a psychological intervention that used cognitive behavioral approaches alone or in combination with another strategy

What (Study Measures): Pain intensity was the main outcome; other outcomes included catastrophizing beliefs and self-efficacy (the belief you can succeed) in managing pain, pain interference, depressive symptoms, anxiety, physical function and health.

How (Study Design): This was a systematic review and meta-analysis. A meta-analysis combines the results of multiple studies identified in a systematic review and quantitatively summarizes the overall association across all studies.

Study Limitations: Limited to English-language studies; few studies evaluated outcomes more than six months after treatment was completed so long-term effects remain poorly understood

Study Conclusions: Efforts are needed to develop and test psychological interventions that have better and more sustainable treatment effects for managing chronic pain in older adults.

Related Material: An author podcast also is available on the For The Media website.

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For more details and to read the full study, please visit the For The Media website.

(doi:10.1001/jamainternmed.2018.0756)

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