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Psychological and Non-Pharmacologic Treatments for Pain in Cancer Patients: A Systematic Review and Meta-Analysis.

Journal of pain and symptom management
May 1, 2022
Alejandra Ruano et al. (4 authors)
Journal ArticleMeta-AnalysisReviewSystematic ReviewResearch Support, Non-U.S. Gov'tHuman Study
Study Details

Study Goal

The researchers aimed to analyze the efficacy of psychological and non-pharmacological treatments, including mindfulness-based cognitive therapy, for reducing pain in cancer patients.

Results Summary

The study found that mindfulness-based cognitive therapy was among the most effective interventions for reducing cancer pain, with a moderate effect size that increased at follow-up. Other interventions like music therapy and brief cognitive behavioral strategies required more research, while coping skills training and yoga did not show positive effects.

Population

Adults with cancer-related pain.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (10)
InterventionDirectionEndpointPopulationDosageImpactClaim #
mindfulness-based cognitive therapy
decrease
cancer pain
patients with cancer pain
-
most effective interventions to reduce
#1
guided imagery
decrease
cancer pain
patients with cancer pain
-
most effective interventions to reduce
#2
progressive muscle relaxation
decrease
cancer pain
patients with cancer pain
-
most effective interventions to reduce
#3
emotional and symptom focused engagement (EASE)
decrease
cancer pain
patients with cancer pain
-
most effective interventions to reduce
#4
music therapy
neutral
cancer pain
patients with cancer pain
-
require more research
#5
brief cognitive behavioral strategies (CBS)
neutral
cancer pain
patients with cancer pain
-
require more research
#6
coping skills training
no change
cancer pain
patients with cancer pain
-
did not show positive effects
#7
yoga
no change
cancer pain
patients with cancer pain
-
did not show positive effects
#8
psychological and non-pharmacologic treatments
decrease
cancer pain
patients with cancer pain
d = 0.642, 95% CI: 0.125-1.158
moderate size effect favourable to
#9
psychological and non-pharmacologic treatments
increase
effect size
patients with cancer pain
k = 5, d = 0.826, 95% CI: 0.141-1.511
increased at follow-up
#10
Abstract

CONTEXT: Pain is the most fearful symptom in cancer. Although there is a relationship between psychosocial variables and oncologic pain, psychological and non-pharmacological treatments for pain management in cancer patients are not very widespread. OBJECTIVES: To analyze the efficacy of psychological and non-pharmacological treatments for reducing pain in cancer patients. METHODS: We performed a systematic review following the PRISMA protocol. In January 2021, data were extracted from PubMed, Web of Science and Scopus, including randomised controlled trials (RCT) published in the last five years (from 28 January, 2015 to December 15, 2020), in the English language and whose sample was patients with cancer pain. The database search used the following keywords: cancer, cancer-related pain, psychological intervention, non-pharmacologic intervention. The Cochrane risk of bias assess ment for randomised trials (RoB 2) was used for quality appraisal. RESULTS: After the inclusion and exclusion criteria were applied, ten papers were fully screened. The evidence suggested that the most effective interventions to reduce cancer pain were mindfulness-based cognitive therapy, guided imagery and progressive muscle relaxation and emotional and symptom focused engagement (EASE). Music therapy and brief cognitive behavioral strategies (CBS) require more research, while coping skills training and yoga did not show positive effects. Overall, we obtained a moderate size effect (d = 0.642, 95% CI: 0.125-1.158) favourable to psychological and non-pharmacologic treatments at post-treatment, which increased at follow-up (k = 5, d = 0.826, 95% CI: 0.141-1.511). CONCLUSION: This study provides insight into psychological interventions which might be applied and contribute to cancer-related pain reduction in adults. Although the results are not completely consistent, they may shed light on psychology applications in the oncology environment.

Medical Subject Headings (MeSH)
AdultCancer PainCognitive Behavioral TherapyHumansMusic TherapyNeoplasmsPain Management
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality85/10
Citation Metrics
Total Citations41
Citations/Year13.7
Relative Citation Ratio6.30
NIH Percentile95.2%
Research Impact Scores
APT Score0.95
Weight Score3.04
Normalized Score0.67
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