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Published in: Systematic Reviews 1/2015

Open Access 01-12-2015 | Research

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

Authors: Louise J. Geneen, Denis J. Martin, Nicola Adams, Clare Clarke, Martin Dunbar, Derek Jones, Paul McNamee, Pat Schofield, Blair H. Smith

Published in: Systematic Reviews | Issue 1/2015

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Abstract

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.
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Literature
4.
5.
go back to reference Eccleston C, Fisher E, Craig L, Duggan R, Keogh E. Psychological therapies (internet delivered) for the management of chronic pain in adults (Protocol). Cochrane Database Syst Rev. 2013;7. Eccleston C, Fisher E, Craig L, Duggan R, Keogh E. Psychological therapies (internet delivered) for the management of chronic pain in adults (Protocol). Cochrane Database Syst Rev. 2013;7.
6.
go back to reference SIGN 136: Management of chronic pain. 2013. SIGN 136: Management of chronic pain. 2013.
8.
go back to reference Wieland L, Skoetz N, Manheimer E, Pilkington K, Vempati R, Berman B. Yoga treatment for chronic non-specific low-back pain [Protocol]. Cochrane Database Syst Rev. 2013;(7):Art. No.: CD010671. doi:10.1002/14651858.CD010671. Wieland L, Skoetz N, Manheimer E, Pilkington K, Vempati R, Berman B. Yoga treatment for chronic non-specific low-back pain [Protocol]. Cochrane Database Syst Rev. 2013;(7):Art. No.: CD010671. doi:10.​1002/​14651858.​CD010671.
9.
go back to reference Review Manager (RevMan). [Computer program]. Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration; 2014. Review Manager (RevMan). [Computer program]. Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration; 2014.
10.
go back to reference Higgins J, Green S. The Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 edition. The Cochrane Collaboration, 2011; 2011. Higgins J, Green S. The Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 edition. The Cochrane Collaboration, 2011; 2011.
11.
go back to reference Linton S, Hellsing A, Larsson I. Bridging the Gap: support groups do not enhance long-term outcome in chronic back pain. Clin J Pain. 1997;13(3):221–8.PubMed Linton S, Hellsing A, Larsson I. Bridging the Gap: support groups do not enhance long-term outcome in chronic back pain. Clin J Pain. 1997;13(3):221–8.PubMed
12.
go back to reference Morrison G, Chase W, Young V, Roberts W. Back pain: treatment and prevention in a community hospital. Arch Phys Med Rehabil. 1988;69:605–9.PubMed Morrison G, Chase W, Young V, Roberts W. Back pain: treatment and prevention in a community hospital. Arch Phys Med Rehabil. 1988;69:605–9.PubMed
13.
go back to reference Gagliese L. Pain and aging: the emergence of a new subfield of pain research. Pain. 2009;10(4):243–53. Gagliese L. Pain and aging: the emergence of a new subfield of pain research. Pain. 2009;10(4):243–53.
16.
go back to reference Schofield P, Clarke A, Jones D, Martin D, McNamee P, Smith B. Chronic pain in later life: a review of current issues and challenges. Ageing Heal. 2011;7(4):1–7. Schofield P, Clarke A, Jones D, Martin D, McNamee P, Smith B. Chronic pain in later life: a review of current issues and challenges. Ageing Heal. 2011;7(4):1–7.
17.
go back to reference Ferrell B, Josephson K, Pollan A, Ferrell B. A randomised trial of walking versus physical methods for chronic pain management. Aging Clin Exp Res. 1997;9(1/2):99–105. Ferrell B, Josephson K, Pollan A, Ferrell B. A randomised trial of walking versus physical methods for chronic pain management. Aging Clin Exp Res. 1997;9(1/2):99–105.
18.
go back to reference Gallagher L, McAuley J, Moseley GL. A randomized-controlled trial of using a book of metaphors to reconceptualize pain and decrease catastrophizing in people with chronic pain. Clin J Pain. 2013;29(1):20–5. doi:10.1097/AJP.0b013e3182465cf7.PubMed Gallagher L, McAuley J, Moseley GL. A randomized-controlled trial of using a book of metaphors to reconceptualize pain and decrease catastrophizing in people with chronic pain. Clin J Pain. 2013;29(1):20–5. doi:10.​1097/​AJP.​0b013e3182465cf7​.PubMed
19.
go back to reference Moseley GL, Nicholas MK, Hodges PW. A randomized controlled trial of intensive neurophysiology education in chronic low back pain. Clin J Pain. 2004;20(5):324–30.PubMed Moseley GL, Nicholas MK, Hodges PW. A randomized controlled trial of intensive neurophysiology education in chronic low back pain. Clin J Pain. 2004;20(5):324–30.PubMed
21.
go back to reference Soares JJF, Grossi G. A randomized, controlled comparison of educational and behavioural interventions for women with fibromyalgia. Scand J Occup Ther. 2002;9:35–45. Soares JJF, Grossi G. A randomized, controlled comparison of educational and behavioural interventions for women with fibromyalgia. Scand J Occup Ther. 2002;9:35–45.
22.
go back to reference Sparkes V, Chidwick N, Coales P. Effect of The Back Book on fear-avoidance beliefs, disability, and pain levels in subjects with low back pain. Int J Ther Rehabil. 2012;19(2):79–86. Sparkes V, Chidwick N, Coales P. Effect of The Back Book on fear-avoidance beliefs, disability, and pain levels in subjects with low back pain. Int J Ther Rehabil. 2012;19(2):79–86.
23.
go back to reference Van Oosterwijck J, Meeus M, Paul L, et al. Pain physiology education improves health status and endogenous pain inhibition in fibromyalgia. Clin. 2013;29(10):873–82. Van Oosterwijck J, Meeus M, Paul L, et al. Pain physiology education improves health status and endogenous pain inhibition in fibromyalgia. Clin. 2013;29(10):873–82.
25.
go back to reference Lefort SM, Gray-donald K, Rowat KM, Ellen M. Randomized controlled trial of a community-based psychoeducation program for the self-management of chronic pain. Pain. 1998;74:297–306.PubMed Lefort SM, Gray-donald K, Rowat KM, Ellen M. Randomized controlled trial of a community-based psychoeducation program for the self-management of chronic pain. Pain. 1998;74:297–306.PubMed
26.
go back to reference Vlaeyen J, Teeken-Gruben N, Goossens M, et al. Cognitive-educational treatment of fibromyalgia: a randomized clinical trial. I Clin Effects J Rheumatol. 1996;23(7):1237–45. Vlaeyen J, Teeken-Gruben N, Goossens M, et al. Cognitive-educational treatment of fibromyalgia: a randomized clinical trial. I Clin Effects J Rheumatol. 1996;23(7):1237–45.
27.
go back to reference Burckhardt C, Mannerkorpi K, Hedenberg L, Bjelle A. A randomized, controlled clinical trial of education and physical training for women with Fibromyalgia. J Rheumatol. 1994;21:714–20.PubMed Burckhardt C, Mannerkorpi K, Hedenberg L, Bjelle A. A randomized, controlled clinical trial of education and physical training for women with Fibromyalgia. J Rheumatol. 1994;21:714–20.PubMed
29.
go back to reference Michelotti A, Voilaro S, Steenks MH, Fareiia M. Evaluation of the short-term effectiveness of education versus an occlusal splint for the treatment of myofascial pain of the jaw muscles. J Orofacial Pain J Am Dental Assoc JADA. 2012;143:47–53. Michelotti A, Voilaro S, Steenks MH, Fareiia M. Evaluation of the short-term effectiveness of education versus an occlusal splint for the treatment of myofascial pain of the jaw muscles. J Orofacial Pain J Am Dental Assoc JADA. 2012;143:47–53.
30.
go back to reference Dush D. Effectiveness of home-study extended patient education for chronic pain. Am J Pain Manag. 2006;16(1):5–11. Dush D. Effectiveness of home-study extended patient education for chronic pain. Am J Pain Manag. 2006;16(1):5–11.
31.
go back to reference Dworkin SF, State W, Foundation D, et al. A randomized clinical trial using research diagnostic criteria for temporomandibular disorders-axis II to target clinic cases for a tailored self-care TMD treatment program. J Orofac Pain. 2002;16(1):48–63.PubMed Dworkin SF, State W, Foundation D, et al. A randomized clinical trial using research diagnostic criteria for temporomandibular disorders-axis II to target clinic cases for a tailored self-care TMD treatment program. J Orofac Pain. 2002;16(1):48–63.PubMed
32.
go back to reference Dirmaier J, Härter M, Weymann N. A tailored, dialogue-based health communication application for patients with chronic low back pain : study protocol of a randomised controlled trial. BMC Med Inform Decis Mak. 2013;13(66). doi:10.1186/1472-6947-13-66. Dirmaier J, Härter M, Weymann N. A tailored, dialogue-based health communication application for patients with chronic low back pain : study protocol of a randomised controlled trial. BMC Med Inform Decis Mak. 2013;13(66). doi:10.​1186/​1472-6947-13-66.
34.
go back to reference Van Ittersum MW, van Wilgen CP, Groothoff JW, van der Schans CP. Is appreciation of written education about pain neurophysiology related to changes in illness perceptions and health status in patients with fibromyalgia? Patient Educ Couns. 2011;85(2):269–74. doi:10.1016/j.pec.2010.09.006.PubMed Van Ittersum MW, van Wilgen CP, Groothoff JW, van der Schans CP. Is appreciation of written education about pain neurophysiology related to changes in illness perceptions and health status in patients with fibromyalgia? Patient Educ Couns. 2011;85(2):269–74. doi:10.​1016/​j.​pec.​2010.​09.​006.PubMed
35.
36.
go back to reference Louw A, Diener I, Butler DS, Puentedura EJ. The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain. YAPMR. 2011;92(12):2041–56. doi:10.1016/j.apmr.2011.07.198. Louw A, Diener I, Butler DS, Puentedura EJ. The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain. YAPMR. 2011;92(12):2041–56. doi:10.​1016/​j.​apmr.​2011.​07.​198.
39.
go back to reference Yu H, Cote P, Southerst D, et al. Does structured patient education improve the recovery and clinical outcomes of patients with neck pain ? A systematic review from the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Spine J. 2014;(in press). doi:10.1016/j.spinee.2014.03.039. Yu H, Cote P, Southerst D, et al. Does structured patient education improve the recovery and clinical outcomes of patients with neck pain ? A systematic review from the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Spine J. 2014;(in press). doi:10.​1016/​j.​spinee.​2014.​03.​039.
40.
go back to reference Bennett MI, Bagnall A, Raine G, et al. Educational interventions by pharmacists to patients with chronic pain. Clin J Pain. 2011;27(7):623–30.PubMed Bennett MI, Bagnall A, Raine G, et al. Educational interventions by pharmacists to patients with chronic pain. Clin J Pain. 2011;27(7):623–30.PubMed
41.
go back to reference Ospina MB, Taenzer P, Rashiq S, et al. A systematic review of the effectiveness of knowledge translation interventions for chronic noncancer pain management. Pain Res Manag. 2013;18(6):129–41. Ospina MB, Taenzer P, Rashiq S, et al. A systematic review of the effectiveness of knowledge translation interventions for chronic noncancer pain management. Pain Res Manag. 2013;18(6):129–41.
42.
go back to reference Andrade SC, Araújo AGR, Vilar MJ. Escola de coluna para pacientes com lombalgia cronica inespecifica: Beneficios da associacao de exercicios e educacao ao paciente. Acta Reumatol Port. 2008;33:443–50.PubMed Andrade SC, Araújo AGR, Vilar MJ. Escola de coluna para pacientes com lombalgia cronica inespecifica: Beneficios da associacao de exercicios e educacao ao paciente. Acta Reumatol Port. 2008;33:443–50.PubMed
Metadata
Title
Effects of education to facilitate knowledge about chronic pain for adults: a systematic review with meta-analysis
Authors
Louise J. Geneen
Denis J. Martin
Nicola Adams
Clare Clarke
Martin Dunbar
Derek Jones
Paul McNamee
Pat Schofield
Blair H. Smith
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2015
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-015-0120-5

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