The effectiveness of various computer-based interventions for patients with chronic pain or functional somatic syndromes

A systematic review and meta-analysis

M.A.P. Vugts, M.C.W. Joosen, J.E. van der Geer, A.M.E.E. Zedlitz, H.J.M. Vrijhoef

Research output: Contribution to journalArticleScientificpeer-review

7 Downloads (Pure)

Abstract

Computer-based interventions target improvement of physical and emotional functioning in patients with chronic pain and functional somatic syndromes. However, it is unclear to what extent which interventions work and for whom. This systematic review and meta-analysis (registered at PROSPERO, 2016: CRD42016050839) assesses efficacy relative to passive and active control conditions, and explores patient and intervention factors. Controlled studies were identified from MEDLINE, EMBASE, PsychInfo, Web of Science, and Cochrane Library. Pooled standardized mean differences by comparison type, and somatic symptom, health-related quality of life, functional interference, catastrophizing, and depression outcomes were calculated at post-treatment and at 6 or more months follow-up. Risk of bias was assessed. Sub-group analyses were performed by patient and intervention characteristics when heterogeneous outcomes were observed. Maximally, 30 out of 46 eligible studies and 3,387 participants were included per meta-analysis. Mostly, internet-based cognitive behavioral therapies were identified. Significantly higher patient reported outcomes were found in comparisons with passive control groups (standardized mean differences ranged between -.41 and -.18), but not in comparisons with active control groups (SMD = -.26 - -.14). For some outcomes, significant heterogeneity related to patient and intervention characteristics.

To conclude, there is a minority of good quality evidence for small positive average effects of computer-based (cognitive) behavior change interventions, similar to traditional modes. These effects may be sustainable. Indications were found as of which interventions work better or more consistently across outcomes for which patients. Future process analyses are recommended in the aim of better understanding individual chances of clinically relevant outcomes.
Original languageEnglish
Article numbere0196467
Number of pages27
JournalPLoS ONE
Volume13
Issue number5
DOIs
Publication statusPublished - 2018

Fingerprint

Chronic Pain
Surface mount technology
Library Science
Health
Internet
MEDLINE
Depression

Keywords

  • CHRONIC BACK-PAIN
  • COGNITIVE-BEHAVIORAL THERAPY
  • COMMITMENT THERAPY
  • COST-EFFECTIVENESS
  • HELP INTERVENTIONS
  • INTERNET-BASED REHABILITATION
  • IRRITABLE-BOWEL-SYNDROME
  • PSYCHOLOGICAL TREATMENTS
  • RANDOMIZED-CONTROLLED-TRIAL
  • SELF-MANAGEMENT PROGRAM

Cite this

@article{1211889a1aaf4c9f828f3f8802ddafa8,
title = "The effectiveness of various computer-based interventions for patients with chronic pain or functional somatic syndromes: A systematic review and meta-analysis",
abstract = "Computer-based interventions target improvement of physical and emotional functioning in patients with chronic pain and functional somatic syndromes. However, it is unclear to what extent which interventions work and for whom. This systematic review and meta-analysis (registered at PROSPERO, 2016: CRD42016050839) assesses efficacy relative to passive and active control conditions, and explores patient and intervention factors. Controlled studies were identified from MEDLINE, EMBASE, PsychInfo, Web of Science, and Cochrane Library. Pooled standardized mean differences by comparison type, and somatic symptom, health-related quality of life, functional interference, catastrophizing, and depression outcomes were calculated at post-treatment and at 6 or more months follow-up. Risk of bias was assessed. Sub-group analyses were performed by patient and intervention characteristics when heterogeneous outcomes were observed. Maximally, 30 out of 46 eligible studies and 3,387 participants were included per meta-analysis. Mostly, internet-based cognitive behavioral therapies were identified. Significantly higher patient reported outcomes were found in comparisons with passive control groups (standardized mean differences ranged between -.41 and -.18), but not in comparisons with active control groups (SMD = -.26 - -.14). For some outcomes, significant heterogeneity related to patient and intervention characteristics.To conclude, there is a minority of good quality evidence for small positive average effects of computer-based (cognitive) behavior change interventions, similar to traditional modes. These effects may be sustainable. Indications were found as of which interventions work better or more consistently across outcomes for which patients. Future process analyses are recommended in the aim of better understanding individual chances of clinically relevant outcomes.",
keywords = "CHRONIC BACK-PAIN, COGNITIVE-BEHAVIORAL THERAPY, COMMITMENT THERAPY, COST-EFFECTIVENESS, HELP INTERVENTIONS, INTERNET-BASED REHABILITATION, IRRITABLE-BOWEL-SYNDROME, PSYCHOLOGICAL TREATMENTS, RANDOMIZED-CONTROLLED-TRIAL, SELF-MANAGEMENT PROGRAM",
author = "M.A.P. Vugts and M.C.W. Joosen and {van der Geer}, J.E. and A.M.E.E. Zedlitz and H.J.M. Vrijhoef",
year = "2018",
doi = "10.1371/journal.pone.0196467",
language = "English",
volume = "13",
journal = "PLoS ONE",
issn = "1932-6203",
publisher = "PUBLIC LIBRARY SCIENCE",
number = "5",

}

The effectiveness of various computer-based interventions for patients with chronic pain or functional somatic syndromes : A systematic review and meta-analysis. / Vugts, M.A.P.; Joosen, M.C.W.; van der Geer, J.E.; Zedlitz, A.M.E.E.; Vrijhoef, H.J.M.

In: PLoS ONE, Vol. 13, No. 5, e0196467, 2018.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - The effectiveness of various computer-based interventions for patients with chronic pain or functional somatic syndromes

T2 - A systematic review and meta-analysis

AU - Vugts, M.A.P.

AU - Joosen, M.C.W.

AU - van der Geer, J.E.

AU - Zedlitz, A.M.E.E.

AU - Vrijhoef, H.J.M.

PY - 2018

Y1 - 2018

N2 - Computer-based interventions target improvement of physical and emotional functioning in patients with chronic pain and functional somatic syndromes. However, it is unclear to what extent which interventions work and for whom. This systematic review and meta-analysis (registered at PROSPERO, 2016: CRD42016050839) assesses efficacy relative to passive and active control conditions, and explores patient and intervention factors. Controlled studies were identified from MEDLINE, EMBASE, PsychInfo, Web of Science, and Cochrane Library. Pooled standardized mean differences by comparison type, and somatic symptom, health-related quality of life, functional interference, catastrophizing, and depression outcomes were calculated at post-treatment and at 6 or more months follow-up. Risk of bias was assessed. Sub-group analyses were performed by patient and intervention characteristics when heterogeneous outcomes were observed. Maximally, 30 out of 46 eligible studies and 3,387 participants were included per meta-analysis. Mostly, internet-based cognitive behavioral therapies were identified. Significantly higher patient reported outcomes were found in comparisons with passive control groups (standardized mean differences ranged between -.41 and -.18), but not in comparisons with active control groups (SMD = -.26 - -.14). For some outcomes, significant heterogeneity related to patient and intervention characteristics.To conclude, there is a minority of good quality evidence for small positive average effects of computer-based (cognitive) behavior change interventions, similar to traditional modes. These effects may be sustainable. Indications were found as of which interventions work better or more consistently across outcomes for which patients. Future process analyses are recommended in the aim of better understanding individual chances of clinically relevant outcomes.

AB - Computer-based interventions target improvement of physical and emotional functioning in patients with chronic pain and functional somatic syndromes. However, it is unclear to what extent which interventions work and for whom. This systematic review and meta-analysis (registered at PROSPERO, 2016: CRD42016050839) assesses efficacy relative to passive and active control conditions, and explores patient and intervention factors. Controlled studies were identified from MEDLINE, EMBASE, PsychInfo, Web of Science, and Cochrane Library. Pooled standardized mean differences by comparison type, and somatic symptom, health-related quality of life, functional interference, catastrophizing, and depression outcomes were calculated at post-treatment and at 6 or more months follow-up. Risk of bias was assessed. Sub-group analyses were performed by patient and intervention characteristics when heterogeneous outcomes were observed. Maximally, 30 out of 46 eligible studies and 3,387 participants were included per meta-analysis. Mostly, internet-based cognitive behavioral therapies were identified. Significantly higher patient reported outcomes were found in comparisons with passive control groups (standardized mean differences ranged between -.41 and -.18), but not in comparisons with active control groups (SMD = -.26 - -.14). For some outcomes, significant heterogeneity related to patient and intervention characteristics.To conclude, there is a minority of good quality evidence for small positive average effects of computer-based (cognitive) behavior change interventions, similar to traditional modes. These effects may be sustainable. Indications were found as of which interventions work better or more consistently across outcomes for which patients. Future process analyses are recommended in the aim of better understanding individual chances of clinically relevant outcomes.

KW - CHRONIC BACK-PAIN

KW - COGNITIVE-BEHAVIORAL THERAPY

KW - COMMITMENT THERAPY

KW - COST-EFFECTIVENESS

KW - HELP INTERVENTIONS

KW - INTERNET-BASED REHABILITATION

KW - IRRITABLE-BOWEL-SYNDROME

KW - PSYCHOLOGICAL TREATMENTS

KW - RANDOMIZED-CONTROLLED-TRIAL

KW - SELF-MANAGEMENT PROGRAM

U2 - 10.1371/journal.pone.0196467

DO - 10.1371/journal.pone.0196467

M3 - Article

VL - 13

JO - PLoS ONE

JF - PLoS ONE

SN - 1932-6203

IS - 5

M1 - e0196467

ER -