A Systematic Review of Technology-assisted Self-Management Interventions for Chronic Pain

Heapy, Alicia; Higgins, Diana M.; Cervone, Dana J; Wandner, Laura D.; Fenton, Brenda T.; Kerns, Robert D.

doi:10.1097/ajp.0000000000000185

Cited by 117 publications

(104 citation statements)

References 64 publications

(248 reference statements)

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“…This most assuredly includes delivery of self-management interventions for a variety of chronic conditions including chronic pain [28]. Perhaps best demonstrated is the potential for Internet-based applications for migraineurs, with publications to date reporting promise for web-based treatment applications targeting adults [29][30][31][32] and children/adolescents alike [33][34][35].…”

Section: Technology-assisted Self-management Interventionsmentioning

confidence: 98%

Well-Established and Empirically Supported Behavioral Treatments for Migraine

Penzien

Irby

Smitherman

et al. 2015

Curr Pain Headache Rep

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This paper provides an overview of the well-established and empirically supported behavioral interventions for the treatment of migraine. The considerable evidence base addressing behavioral interventions amassed since 1969 has conclusively established the efficacy of therapies featuring combinations of relaxation, biofeedback, and stress management training, and demonstrated they are capable of yielding benefits on par with pharmacological therapies for migraine. Behavioral interventions also are well suited for delivery across a variety of different contexts (e.g., group vs. individual, standard clinic vs. limited therapist contact, face-to-face vs. technology-assisted). Despite the amply established efficacy and effectiveness of these self-management interventions for the treatment of migraine, the availability and implementation of these approaches remain limited for many headache sufferers. We anticipate the technological advances in delivery platforms will provide better access to behavioral self-management strategies for migraine.

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Section: Technology-assisted Self-management Interventionsmentioning

confidence: 98%

Well-Established and Empirically Supported Behavioral Treatments for Migraine

Penzien

Irby

Smitherman

et al. 2015

Curr Pain Headache Rep

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“…As noted by Heapy et al, one approach would be to conduct research that directly compares different eHealth modalities [21]. In particular, research should focus on conducting trials with mobile applications for chronic pain.…”

Section: Discussionmentioning

confidence: 99%

“…Much eHealth research has been conducted in the area of chronic pain, and eHealth interventions have shown to be efficacious [40]. However, despite the increasing variety of eHealth modalities used for chronic pain, studies typically focus on one modality and as a result, direct comparisons of modalities are rare [21]. Identifying the need to investigate the relative strengths and weaknesses of modality types, Heapy and colleagues conducted a systematic review of technology-assisted self-management interventions for chronic pain, in which three modality types were evaluated; namely, telephone, interactive voice response and internet.…”

Section: Ehealth and Chronic Painmentioning

confidence: 99%

“…The core value proposition for delivering healthcare via an eHealth modality is that the barriers experienced by traditional in-person treatment methods are reduced or potentially removed [18,19,20,21,4]. For instance, an online eHealth intervention may improve accessibility to treatment, reduce the waiting list duration and can be delivered more costeffectively than in-person services (e.g., [22]).…”

Section: Introduction Ehealthmentioning

confidence: 99%

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An Evaluation of the Effectiveness of the Modalities Used to Deliver Electronic Health Interventions for Chronic Pain: Systematic Review With Network Meta-Analysis (Preprint)

Slattery¹,

Haugh²,

O’Connor³

et al. 2018

Preprint

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Abstract:Background: eHealth is the use of information and communication technology in the context of healthcare and health research. Recently, there has been a rise in the number of eHealth modalities and the frequency in which they are used to deliver technology-assisted self-management interventions for people living with chronic pain. However, there has been little or no research directly comparing these eHealth modalities. Objective:The aim of the current systematic review with a network meta-analysis is to directly compare the effectiveness of eHealth modalities in the context of chronic pain. Methods:Randomised controlled trials (N>20 per arm) that investigated technologically delivered interventions for adults with chronic pain were included. Data were extracted on pain severity, psychological distress and HRQoL, and the risk of bias was assessed. Studies were classified by their primary mode of delivery. Pair-wise meta-analyses were undertaken and a network meta-analysis was conducted to generate indirect comparisons of modalities for reducing pain severity. Results:The search returned 18,470 studies with 18,349 excluded (duplicates [2,310]; title and abstract [16,039]). Of the remaining papers, 30 studies with 4,595 randomised participants were included in the review. Rankings tentatively indicate that telephone supported interventions are the most effective, with a 46% chance that telephone intervention was the best modality, followed by studies delivered via interactive voice response, internet and virtual reality. Conclusions:This current systematic review with a network meta-analysis generated comparisons between previously un-compared technological modalities to determine which delivered the most effective interventions for the reduction of pain severity in chronic pain patients. There are limitations with this review; in particular, the underrepresented nature of some eHealth modalities included in the analysis. However, in the event that the review is regularly updated a clear ranking of eHealth modalities for the reduction of pain severity will emerge.

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“…For treatment and/or maintenance treatment of CWP an alternative may be internet CBT and smartphone interventions [6,7]. Such technology-supported interventions are increasingly used to support people with health problems including chronic pain in self-management, and show effects similar to that of face-to-face CBT [8][9][10][11][12][13][14][15]. Studies that, in addition to internet CBT, which have used methods of communicating with participants, such as short message service (SMS), appear to be even more effective in supporting behavioral change [16].…”

Section: Introductionmentioning

confidence: 99%

Analyzing Change Processes Resulting from a Smartphone Maintenance Intervention Based on Acceptance and Commitment Therapy for Women with Chronic Widespread Pain

et al. 2016

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PURPOSEThis study investigated change processes resulting from a smartphone maintenance intervention with daily electronic diaries and personalized written feedback based on Acceptance and Commitment Therapy following a rehabilitation program for patients with chronic widespread pain. METHODSThe RCT included 48 women who, during a 5-week period, completed electronic diaries 3 times daily, totaling 3372 entries. In response to the completed diaries they received daily feedback from a therapist during 4 weeks, except during weekends, totaling 799 feedback messages. To analyze the change processes resulting from the smartphone intervention, we explored the associations between feedback and daily ratings of participant's physical activities, positive emotions, fear avoidance, acceptance and self-management. Commitment to physical activities and the participants' evaluation of feedback were also analyzed. Multilevel models were used in the statistical analyses. RESULTSParticipants' average "pain fear and avoidance" decreased over the intervention period (Mean -0.019, P = 0.05).Self-management, pain acceptance and positive feelings increased (Mean -0.030, P <.01, Mean -0.015, P = <.01and Mean -0.011, P = 0.01). Participants' performance of physical activities decreased slightly over time, but the level of commitment was high and they evaluated the feedback as supportive for staying sufficiently active. No correlation between diary contents and feedback messages was found, even though most of the participants evaluated the feedback as supportive. CONCLUSIONSNo support for a relationship between ACT consistent diary content and feedback was found. However, diary measures were consistent with the ACT model and may have influenced positively the change processes.3

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A Systematic Review of Technology-assisted Self-Management Interventions for Chronic Pain

Cited by 117 publications

References 64 publications

Well-Established and Empirically Supported Behavioral Treatments for Migraine

Well-Established and Empirically Supported Behavioral Treatments for Migraine

An Evaluation of the Effectiveness of the Modalities Used to Deliver Electronic Health Interventions for Chronic Pain: Systematic Review With Network Meta-Analysis (Preprint)

Analyzing Change Processes Resulting from a Smartphone Maintenance Intervention Based on Acceptance and Commitment Therapy for Women with Chronic Widespread Pain

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