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Fritsch CG, Ferreira ML, da Silva AKF, et al. Family-based Interventions Benefit Individuals With Musculoskeletal Pain in the Short-term but not in the Long-Term: A Systematic Review and Meta-Analysis. Clin J Pain. 2021 Feb 1;37(2):140-157. doi: 10.1097/AJP.0000000000000897. (Systematic review)
Abstract

INTRODUCTION: The benefits of family-based interventions for patients with musculoskeletal pain have been previously shown in individual randomized controlled trials (RCTs), but no systematic review has summarized their effects.

MATERIALS AND METHODS: A systematic review was conducted to assess the effectiveness of family-based interventions on clinical and biopsychosocial outcomes in people with musculoskeletal pain (PROSPERO CRD42018118442). Meta-analyses were performed for the outcomes of pain intensity, disability, mood, self-efficacy, and marital adjustment.

RESULTS: Of 1223 records identified, 18 reports representing 15 RCTs were included in the qualitative review and 10 in the meta-analyses. Family-based interventions were more effective to reduce pain (mean difference [MD], -3.55/100; 95% confidence intreval [CI], -4.03 to -3.06) and disability (MD, -1.51/100; 95% CI, -1.98 to -1.05) than individual-focused interventions at short-term, but not at mid term or long term. There were no effects on other outcomes. Family-based interventions were more effective to reduce pain (MD, -6.05/100; 95% CI, -6.78 to -5.33) compared with usual care only at short-term. No effects were found on disability and other outcomes.

DISCUSSION: There is moderate-quality evidence that family-based interventions result in small, significantly better pain and disability outcomes in the short-term compared with individual-focused interventions in patients with musculoskeletal pain. Based on low-quality evidence, family-based interventions result in small improvements on pain in the short-term compared with usual care. Future studies should review the content and optimize the mechanisms underpinning family-based interventions in musculoskeletal pain so that the approach could be further tested in adequately powered RCTs.

Ratings
Discipline Area Score
Rehab Clinician (OT/PT) 5 / 7
Psychologist 5 / 7
Physician 4 / 7
Comments from MORE raters

Psychologist rater

As a clinical psychologist training students to be psychologists, I would have expected these results. The benefit of this article to me is that it provides a good meta-analysis of the evidence when I am consulting my pain management colleagues, students and clients. The article reflects a well conducted RCT with masked allocation and sufficient power to address the issue. I agree with the researcher's two conclusions that future research that further development and tests on family-based interventions on mid- to long-term outcomes in musculoskeletal pain are needed. Future studies should review the content and optimize the mechanisms underpinning family-based interventions in musculoskeletal pain so that the approach could be further tested in adequately powered RCTs.

Rehab Clinician (OT/PT) rater

This article supports what OTs fundamentally recognize; family support is crucial to well being.

Rehab Clinician (OT/PT) rater

What an important piece of literature based research. I do not imagine that occupational therapists generally are aware of the positive impacts of family interventions on pain management and disability in orthopedics. I think that dissemination of this information is very important and has the potential to powerfully impact practice.
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