Psychological interventions for long‐term conditions: a review of approaches, content and outcomes

Abstract

AbstractBackground. People living with long‐term conditions are more likely to see their GP and experience limitations in their daily activities (Department of Health, 2005). Psychological interventions, specifically cognitive behavioural therapy (CBT), aimed at helping people to cope and self‐manage these conditions, are popular. This review aims to summarize the evidence from good‐quality systematic reviews of psychological interventions to inform the management of, and future research in, patients with chronic musculoskeletal pain. Cochrane reviews were used as these are considered to be of good quality (Handoll et al., 2002). Method. We identified Cochrane reviews of psychological interventions for common chronic health conditions in adults across all healthcare settings. Data on intervention approach, content, delivery and outcomes were extracted and summarized. Results. Nine Cochrane reviews, in asthma (n = 1), diabetes (n = 2), coronary heart disease (n = 1) and chronic musculoskeletal pain (n = 5) were identified. These reviews included 131 clinical trials and over 20,200 patients. Psychological interventions were wide ranging, many using a variety of CBT, mostly delivered in secondary care settings by nurses or psychologists. Physiotherapists were involved in some studies as part of multidisciplinary teams. Due to the complexity and diversity of the interventions, individually effective components could not be identified. Interpretation of studies was difficult because of heterogeneity in intervention content, delivery and outcomes measured. Conclusion. Physiotherapists involved in the management of long‐term conditions, particularly chronic musculoskeletal pain, can perhaps learn from this evidence base. Future research should investigate the effectiveness of individual components of CBT and the role of physiotherapists in delivering this type of intervention. Copyright © 2008 John Wiley & Sons, Ltd.