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Effects of education to facilitate knowledge about chronic pain for adults: a systematic review with meta-analysis

BACKGROUND: Chronic pain can contribute to disability, depression, anxiety, sleep disturbances, poor quality of life and increased health care costs, with close to 20 % of the adult population in Europe reporting chronic pain. To empower the person to self-manage, it is advocated that education and...

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Autores principales: Geneen, Louise J., Martin, Denis J., Adams, Nicola, Clarke, Clare, Dunbar, Martin, Jones, Derek, McNamee, Paul, Schofield, Pat, Smith, Blair H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4591560/
https://www.ncbi.nlm.nih.gov/pubmed/26428467
http://dx.doi.org/10.1186/s13643-015-0120-5
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author Geneen, Louise J.
Martin, Denis J.
Adams, Nicola
Clarke, Clare
Dunbar, Martin
Jones, Derek
McNamee, Paul
Schofield, Pat
Smith, Blair H.
author_facet Geneen, Louise J.
Martin, Denis J.
Adams, Nicola
Clarke, Clare
Dunbar, Martin
Jones, Derek
McNamee, Paul
Schofield, Pat
Smith, Blair H.
author_sort Geneen, Louise J.
collection PubMed
description BACKGROUND: Chronic pain can contribute to disability, depression, anxiety, sleep disturbances, poor quality of life and increased health care costs, with close to 20 % of the adult population in Europe reporting chronic pain. To empower the person to self-manage, it is advocated that education and training about the nature of pain and its effects and how to live with pain is provided. The objective of this review is to determine the level of evidence for education to facilitate knowledge about chronic pain, delivered as a stand-alone intervention for adults, to reduce pain and disability. METHODS: We identified randomised controlled trials of educational intervention for chronic pain by searching CENTRAL, MEDLINE, EMBASE and ongoing trials registries (inception to December 2013). Main inclusion criteria were (1) pain >3 months; (2) study design that allowed isolation of effects of education and (3) measures of pain or disability. Two reviewers independently screened and appraised each study. RESULTS: Nine studies were analysed. Pooled data from five studies, where the comparator group was usual care, showed no improvement in pain or disability. In the other four studies, comparing different types of education, there was no evidence for an improvement in pain; although, there was evidence (from one study) of a decrease in disability with a particular form of education—pain neurophysiology education (PNE). Post-hoc analysis of psychosocial outcomes reported in the studies showed evidence of a reduction in catastrophising and an increase of knowledge about pain following PNE. CONCLUSIONS: The evidence base is limited by the small numbers of studies, their relatively small sample sizes, and the diversity in types of education studied. From that limited evidence, the only support for this type of education is for PNE, though it is insufficiently strong to recommend conclusively that PNE should be delivered as a stand-alone intervention. It therefore remains sensible to recommend that education be delivered in conjunction with other pain management approaches as we cannot confidently conclude that education alone is effective in reducing pain intensity or related disability in chronic pain in adults. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13643-015-0120-5) contains supplementary material, which is available to authorized users.
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spelling pubmed-45915602015-10-03 Effects of education to facilitate knowledge about chronic pain for adults: a systematic review with meta-analysis Geneen, Louise J. Martin, Denis J. Adams, Nicola Clarke, Clare Dunbar, Martin Jones, Derek McNamee, Paul Schofield, Pat Smith, Blair H. Syst Rev Research BACKGROUND: Chronic pain can contribute to disability, depression, anxiety, sleep disturbances, poor quality of life and increased health care costs, with close to 20 % of the adult population in Europe reporting chronic pain. To empower the person to self-manage, it is advocated that education and training about the nature of pain and its effects and how to live with pain is provided. The objective of this review is to determine the level of evidence for education to facilitate knowledge about chronic pain, delivered as a stand-alone intervention for adults, to reduce pain and disability. METHODS: We identified randomised controlled trials of educational intervention for chronic pain by searching CENTRAL, MEDLINE, EMBASE and ongoing trials registries (inception to December 2013). Main inclusion criteria were (1) pain >3 months; (2) study design that allowed isolation of effects of education and (3) measures of pain or disability. Two reviewers independently screened and appraised each study. RESULTS: Nine studies were analysed. Pooled data from five studies, where the comparator group was usual care, showed no improvement in pain or disability. In the other four studies, comparing different types of education, there was no evidence for an improvement in pain; although, there was evidence (from one study) of a decrease in disability with a particular form of education—pain neurophysiology education (PNE). Post-hoc analysis of psychosocial outcomes reported in the studies showed evidence of a reduction in catastrophising and an increase of knowledge about pain following PNE. CONCLUSIONS: The evidence base is limited by the small numbers of studies, their relatively small sample sizes, and the diversity in types of education studied. From that limited evidence, the only support for this type of education is for PNE, though it is insufficiently strong to recommend conclusively that PNE should be delivered as a stand-alone intervention. It therefore remains sensible to recommend that education be delivered in conjunction with other pain management approaches as we cannot confidently conclude that education alone is effective in reducing pain intensity or related disability in chronic pain in adults. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13643-015-0120-5) contains supplementary material, which is available to authorized users. BioMed Central 2015-10-01 /pmc/articles/PMC4591560/ /pubmed/26428467 http://dx.doi.org/10.1186/s13643-015-0120-5 Text en © Geneen et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Geneen, Louise J.
Martin, Denis J.
Adams, Nicola
Clarke, Clare
Dunbar, Martin
Jones, Derek
McNamee, Paul
Schofield, Pat
Smith, Blair H.
Effects of education to facilitate knowledge about chronic pain for adults: a systematic review with meta-analysis
title Effects of education to facilitate knowledge about chronic pain for adults: a systematic review with meta-analysis
title_full Effects of education to facilitate knowledge about chronic pain for adults: a systematic review with meta-analysis
title_fullStr Effects of education to facilitate knowledge about chronic pain for adults: a systematic review with meta-analysis
title_full_unstemmed Effects of education to facilitate knowledge about chronic pain for adults: a systematic review with meta-analysis
title_short Effects of education to facilitate knowledge about chronic pain for adults: a systematic review with meta-analysis
title_sort effects of education to facilitate knowledge about chronic pain for adults: a systematic review with meta-analysis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4591560/
https://www.ncbi.nlm.nih.gov/pubmed/26428467
http://dx.doi.org/10.1186/s13643-015-0120-5
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