Brian McGuire1, Eimear Morrissey1, Jonathan Egan1, Angeline Traynor1
1) Ireland
Background: The effectiveness of information and communication technology (ICT)-delivered, psychological interventions for chronic pain management varies considerably. Little consideration is given to the intervention components that may contribute to estimates of effect. Aims: First, to determine the overall effect of ICT-delivered psychological therapies on pain-intensity, pain-interference, psychological distress, quality of life and treatment satisfaction at post-treatment and follow-up among children with chronic pain. Second, to identify the ‘active ingredients’ that may be associated with estimates of effect. Methods: Published and unpublished randomized controlled trials of psychological interventions treating children (<18 years) with chronic pain conditions were searched for and selected. Intervention content was assessed in terms of (i) the theoretical basis, (ii) the presence or absence of behaviour change techniques and the characteristics of intervention delivery. Risk of bias was assessed and quality of the evidence was rated using GRADE. Results: Nine of ten included studies were assessed using random effects meta-analyses. Headache pain was reduced post-treatment (odds ratio (OR) = 3.44, 95% confidence interval (CI) 1.73 to 6.81, z = 3.54, p < 0.001, (NNTB) = 3.91). No effects were found for reducing headache pain at follow-up. Across pain conditions, there were no beneficial effects of ICT-delivered therapies for disability, depression or quality of life at post-treatment or follow-up. The most common characteristics of intervention content and delivery were identified. Studies which include the behaviour change technique ‘action planning’ were beneficial effects when technique was present (SMD = 13.97, p < 0.001), compared to when it was absent (SMD = 2.41, p < 0.01). Conclusions: Technology-based therapies may be beneficial in reducing headache pain intensity at post-treatment. However, there is considerable uncertainty around these estimates of effect. Implications for practice and research are discussed.
