Abstract
BackgroundNumerous psychological risk and protective factors have been identified as contributing to or preventing the development of the prevalent issue of chronic pain. Systematic reviews of studies on psychological interventions that tackle these factors have shown limited effects on chronic pain. Therefore, implementing psychological interventions before pain becomes chronic has been put forward. However, the efficacy of such interventions in preventing the transition from acute to chronic pain has not yet been systematically assessed.MethodsThe aims of this systematic review are to assess the effects of psychological interventions applied in the acute pain phase on pain severity as well as on physical, psychological, and social functions at 3 months and beyond. Randomized controlled trials including psychological intervention as a treatment of primary interest and participants with pain of less than 3 months duration will be considered. The following comparisons will be undertaken: psychological interventions with (1) standard treatment, (2) information, (3) waiting-list, and (4) active treatment. The primary outcome will be pain severity using indicators such the presence or absence of pain and self-report measures such as the numeric pain intensity rating scale. Secondary outcomes will include pain-related disability, mood, coping with pain, quality of life, health care utilization, and work capability. A systematic review of English and French articles in MEDLINE, Embase, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials will be conducted without date restriction. Extracted data will include demographics and clinical characteristics, sample size, intervention and control group types, assessment tools used, time interval of measurement, fidelity of the intervention, and attrition rate. Standardized mean differences (SMD) and risk ratios with 95% confidence intervals (CI) will be used to assess treatment effects.DiscussionThis systematic review is the first in examining the effects of psychological interventions implemented in the acute pain phase with the objective of preventing chronic pain. Results of this systematic review could provide information on psychological intervention characteristics that are most helpful for individuals with pain and guidance as to when such interventions should be applied in the continuum of care.Systematic review registrationPROSPERO CRD42016049312
Highlights
Numerous psychological risk and protective factors have been identified as contributing to or preventing the development of the prevalent issue of chronic pain
Systematic reviews on the epidemiologic literature describing the clinical course of low back pain (LBP) have shown that between 42% and 75% of individuals in industrialized countries that still experience pain 12 months after the first episode [10, 11]
To assess the efficacy of psychological interventions in preventing chronic pain in adults compared with standard treatments, information, waiting list control, and active treatments
Summary
Numerous psychological risk and protective factors have been identified as contributing to or preventing the development of the prevalent issue of chronic pain. Systematic reviews of studies on psychological interventions that tackle these factors have shown limited effects on chronic pain. The efficacy of such interventions in preventing the transition from acute to chronic pain has not yet been systematically assessed. Chronic pain can negatively affect the person’s physical function [3, 4] and psychological health [5,6,7]. This condition is associated with a high socio-economic burden [8, 9]. A recent prospective study has shown that a third of this population develops moderate to severe neuropathic pain at 4 months post-injury [15]
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