PSY84 - A Systematic Review of Population-Based Studies on Pain Self-Management Strategies and Outcomes

Abstract

To conduct a systematic review of population-based studies that identify self-management strategies used by individuals with pain. An electronic search was conducted in seven databases (PubMed, Embase, Cochrane Library, PsycINFO, CINAHL, Web of Science, and International Pharmaceutical Abstracts) using the search terms (and synonyms): pain; self-care; self-management; self-treatment; and adult to identify relevant abstracts. Relevant websites and citations of identified papers were also searched. Titles and abstracts were screened and included for full-text review if they were population-based surveys that collected data on pain self-management strategies in adults published in English between January 1989 and June 2017. Data on subject demographics, pain characteristics, pain self-management strategies, and pain outcomes were extracted. Strategies were organized according to a conceptual model as pharmacological (prescription or non-prescription) or non-pharmacological (medical, physical, psychological, & home remedies). Included studies were assessed for risk of bias. A total of 18 studies were included. Twenty-one pharmacological strategies were identified (15 prescription, 6 non-prescription). Non-steroidal anti-inflammatory drugs were the most commonly reported strategy (15 studies, range of use 10-72%). Twenty-three non-pharmacological strategies were identified: four medical strategies (consulted medical practitioner, injection, surgery, other; 8 studies), ten physical strategies (activity modification/restriction, acupuncture, change body position, assistive device, exercise, hot/cold modalities, massage, physical therapy, transcutaneous electrical nerve stimulation, other; 15 studies), four psychological strategies (prayer/meditation, relaxation, rest/sleep, therapy; 12 studies), and five home remedies (complementary/alternative medicine, chiropractic, dietary/herbal supplements, diet modification, other; 13 studies). Data on outcomes (e.g., impact on daily activities, satisfaction) were reported in 15 studies, although in most instances only limited information was provided. Individuals with pain use a variety of pharmacological and non-pharmacological strategies to manage pain; however, there is little information on how many strategies are used by individuals or how strategies are related to outcomes; thus further research is needed.