The efficacy of Web-based cognitive behavioral interventions for chronic pain: a systematic review and meta-analysis

The Journal of Pain : Official Journal of the American Pain Society
Debora Duarte MaceaFelipe Fregni

Abstract

Our objective was to conduct a systematic review and meta-analysis to quantify the efficacy of web-based cognitive behavioral interventions for the treatment of patients with chronic pain. MEDLINE and other databases were searched as data sources. Reference lists were examined for other relevant articles. We included 11 studies that evaluated the effects of web-based interventions on chronic pain using specific scales of pain. The pooled effect size (standardized mean difference between intervention versus waiting-list group means) from a random effects model was .285 (95% confidence interval: .145-.424), favoring the web-based intervention compared with the waiting-list group, although the effect was small. In addition, these results were not driven by any particular study, as shown by sensitivity analysis. Results from funnel plot argue against publication bias. Finally, the average dropout rate was 26.6%. In our meta-analysis, we demonstrate a small effect of web-based interventions, when using pain scale as the main outcome. Despite the minor effects and high dropout rates, the decreased costs and minor risk of adverse effects compared with pharmacological treatments support additional studies in chronic pain patients using...Continue Reading

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