Psychological and Non-Pharmacologic Treatments for Pain in Cancer Patients: A Systematic Review and Meta-Analysis.
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
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
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 |
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.