Barriers and Facilitators of Evidence-Based Psychotherapies for Chronic Pain in Adults: A Systematic Review

Goldsmith, Elizabeth S.; Miller, Wesley J.; Koffel, Erin; Ullman, Kristen; Landsteiner, Adrienne; Stroebel, Benjamin; Hill, Jennifer G.; Wilt, Timothy J; Duan-Porter, Wei

doi:10.1016/j.jpain.2023.02.026

Cited by 3 publications

(2 citation statements)

References 85 publications

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“…Research into the barriers and facilitators of MBSR implementation has focused on patient level variables. 4 Researcher’s hypothesized that additional likely barriers to MBSR’s integration include lack of procedural guidelines to deliver a group program in the clinic, unfamiliarity with MBSR, uncertain reimbursement, and importantly, lack of stakeholder involvement in MBSR and mindfulness research and dissemination.…”

Section: Introductionmentioning

confidence: 99%

Integrating a Community Advisory Board Into a Pragmatic Trial of Mindfulness for Chronic Low Back Pain

Morone,

Harr,

Baez

et al. 2024

Global Advances in Integrative Medicine and Health

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Background To improve the implementation of clinical trial interventions, there is a need to facilitate communication between key stakeholders and research teams. Community Advisory Boards (CAB) bring together a range of stakeholders not historically included in the research process to inform and work collaboratively with research teams. Objective To describe our procedures and processes for (1) integration of a CAB into a pragmatic clinical trial of a telehealth-delivered group mindfulness program for persons with chronic low back pain (cLBP) within primary care, and (2) for the rapid uptake and implementation of CAB recommendations. Methods The CAB we convened includes persons with cLBP who have undergone the mindfulness intervention, health care system leadership, advocacy groups, and mindfulness experts. The CAB members underwent a two hour initial training that introduced the research process and the CAB’s role as research partners. The CAB met monthly for 1 hour. We used the Lighting Report method to summarize meetings and share feedback with the research team. Results The recommendations of the CAB during the first year they met were divided into recruitment, informed consent, and survey recommendations. The study website also was overhauled based on recommendations, including a more engaging first page with rotating images of nature and testimonials. The language on the website was edited to be more concise and participant-friendly. The CAB recommended talking points to discuss with participants during screening or informed consent about the benefits of participating in research. Conclusion We established a CAB that represented diverse perspectives, organizations, and experience with cLBP and mindfulness. The differing perspectives of the CAB resulted in recommendations that the research team itself would not have decided on their own. The Lightning Reports were also an effective way to efficiently communicate the CAB recommendations to the research team.

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Section: Introductionmentioning

confidence: 99%

Integrating a Community Advisory Board Into a Pragmatic Trial of Mindfulness for Chronic Low Back Pain

Morone,

Harr,

Baez

et al. 2024

Global Advances in Integrative Medicine and Health

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“… 8 In 2019, the World Health Organization advised that access to CBT was essential for evidence-based health care; 9 however, treatment access is an important barrier to care for people with mental health disorders 10 and those with somatic disorders such as chronic pain. 11 Access is particularly an issue in a country as geographically large and sparsely populated as Canada.…”

mentioning

confidence: 99%

Therapist-guided remote versus in-person cognitive behavioural therapy: a systematic review and meta-analysis of randomized controlled trials

Zandieh,

Abdollahzadeh,

Sadeghirad

et al. 2024

CMAJ

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Background: Cognitive behavioural therapy (CBT) has been shown to be effective for several psychiatric and somatic conditions; however, most randomized controlled trials (RCTs) have administered treatment in person and whether remote delivery is similarly effective remains uncertain. We sought to compare the effectiveness of therapist-guided remote CBT and in-person CBT. Methods: We systematically searched MEDLINE, Embase, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials from inception to July 4, 2023, for RCTs that enrolled adults (aged ≥ 18 yr) presenting with any clinical condition and that randomized participants to either therapist-guided remote CBT (e.g., teleconference, videoconference) or in-person CBT. Paired reviewers assessed risk of bias and extracted data independently and in duplicate. We performed random-effects model meta-analyses to pool patient-important primary outcomes across eligible RCTs as standardized mean differences (SMDs). We used Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidance to assess the certainty of evidence and used the Instrument to Assess the Credibility of Effect Modification Analyses (ICEMAN) to rate the credibility of subgroup effects. Results: We included 54 RCTs that enrolled a total of 5463 patients. Seventeen studies focused on treatment of anxiety and related disorders, 14 on depressive symptoms, 7 on insomnia, 6 on chronic pain or fatigue syndromes, 5 on body image or eating disorders, 3 on tinnitus, 1 on alcohol use disorder, and 1 on mood and anxiety disorders. Moderate-certainty evidence showed little to no difference in the effectiveness of therapist-guided remote and in-person CBT on primary outcomes (SMD −0.02, 95% confidence interval −0.12 to 0.07). Interpretation: Moderate-certainty evidence showed little to no difference in the effectiveness of in-person and therapist-guided remote CBT across a range of mental health and somatic disorders, suggesting potential for the use of therapist-guided remote CBT to facilitate greater access to evidence-based care. Systematic review registration: Open Science Framework ( https://osf.io/7asrc )

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Computerised health interventions targeting Australian veterans and their families: A scoping review

McMahon,

Guindalini,

Mellor

2023

Health Prom J of Aust

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Issue AddressedAustralian veterans suffer higher rates of both mental and physical health conditions than civilians, yet many do not seek treatment. Computerised Interventions (CIs) may provide an alternative approach to management, which can overcome some barriers to treatment uptake. We aim to evaluate the scope and quality of CIs designed specifically for Australian veterans and their families.MethodsA manual search of the Department of Veterans' Affairs and other Ex‐service organisation websites was performed to map and describe CIs for Australian veterans and their families, followed by a scoping review of four databases to identify evaluations of relevant CIs.ResultsOur search identified 10 CIs specific to Australian veterans and their families. The majority were structured, self‐guided CIs, designed to elicit cognitive/behavioural change that addressed mental health and psychosocial needs during transition. Three evaluations examined previously identified CIs. The results showed mixed reviews from participants and clinicians, in two separate evaluations, regarding user experience, quality and perceived benefit. In addition, positive psychological outcomes, including the reduction of post‐traumatic stress disorder (PTSD) symptoms, were demonstrated for participants of the online intervention.ConclusionWhile Australian veteran‐centric online interventions primarily focus on psychological conditions, the prevalent physical health concerns within the veteran population remain unaddressed. Additionally, despite the documented impact of military experience on family members, there is a lack of specific Australian interventions designed for families. Few tools have been formally evaluated, yet show promise as supportive self‐directed resources for veterans with PTSD, and for navigating transition challenges.So What?Further development of online interventions addressing prevalent physical and family needs, and conduction of comprehensive evaluations are needed to enhance overall quality, accessibility and holistic effectiveness of interventions for the Australian veteran community.

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Barriers and Facilitators of Evidence-Based Psychotherapies for Chronic Pain in Adults: A Systematic Review

Cited by 3 publications

References 85 publications

Integrating a Community Advisory Board Into a Pragmatic Trial of Mindfulness for Chronic Low Back Pain

Integrating a Community Advisory Board Into a Pragmatic Trial of Mindfulness for Chronic Low Back Pain

Therapist-guided remote versus in-person cognitive behavioural therapy: a systematic review and meta-analysis of randomized controlled trials

Computerised health interventions targeting Australian veterans and their families: A scoping review

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