Psychological therapies delivered remotely for the management of chronic pain (excluding headache) in adults

Cochrane Database of Systematic Reviews, 2023 · DOI: 10.1002/14651858.CD013863.pub2 · Published: August 1, 2023

Mental Health Pain Management Telehealth & Digital Health

Simple Explanation

This review examines whether psychological therapies delivered remotely (e.g., via the internet or smartphone apps) can help adults manage chronic pain, excluding headaches. The review found that online cognitive behavioral therapy (CBT) may improve pain and disability in people with chronic pain. More research is needed to explore other types of remote therapies and to understand their potential benefits and risks.

Study Duration

Not specified

Participants

4924 adults with chronic pain

Evidence Level

Systematic Review of RCTs

Key Findings

1
Remotely-delivered CBT shows small benefits for pain intensity and functional disability in adults experiencing chronic pain.
2
The benefits of online CBT compared to usual treatment are probably no longer present at 3 to 12 months after treatment ends.
3
Evidence about the number of people experiencing adverse events is very uncertain.

Research Summary

This review included 32 studies with 4924 participants to evaluate the efficacy of remotely-delivered psychological interventions for chronic pain in adults. The most common remotely-delivered psychological therapy was cognitive behavioral therapy (CBT). Remotely-delivered CBT likely results in a slight reduction in pain intensity and functional disability compared to treatment as usual, but these effects were not maintained at follow-up.

Practical Implications

For Practice

Remotely delivered CBT may provide small, short-term benefits for pain intensity, functional disability, anxiety, and depression compared to treatment as usual.

For Policy

Policy-makers may consider remote delivery options to improve access to psychological therapies for adults experiencing chronic pain.

For Research

Further research is needed to explore a wider range of psychological therapies, different delivery technologies, and potential harm associated with remote delivery.

Study Limitations

1
Evidence is primarily limited to Internet-based CBT interventions.
2
Limited data on adverse events, intervention satisfaction, and engagement.
3
The certainty of the evidence ranged from moderate to very low due to study quality, inconsistency, or imprecision.

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