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Fechner R, Verhagen A, Alcock M, et al. The Effectiveness of Pain Science Education on Caregiver and Children's Knowledge, Beliefs, Attitudes, and Behaviors-A Systematic Review and Meta-Analysis. J Pain. 2024 Sep;25(9):104578. doi: 10.1016/j.jpain.2024.104578. Epub 2024 May 23. (Systematic review)
Abstract

Pain science education (PSE) can be used as part of treatment and prevention for chronic pain in children. We assessed the effectiveness of PSE on knowledge, beliefs, attitudes, and behaviors in children and the people that care for children. We set a minimum criterion for education to address pain biology knowledge. We included studies aimed at both treatment and prevention of chronic pain. We conducted searches using 5 databases. We assessed the risk of bias using the Cochrane Risk of Bias 2 tool. Data were pooled using a random-effects meta-analysis or assessed using a narrative synthesis. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation. We screened 14,505 records and included 7 studies involving 351 caregivers and 1,285 children. Four studies were included in meta-analyses. We found low-certainty evidence that PSE has a large beneficial effect on caregiver knowledge and beliefs compared with alternative education (standardized mean difference = 1.14 [95% confidence interval: .88-1.42]; I2 = 0%). We found no difference in functional disability in children with chronic pain after PSE (Functional Disability Inventory score mean difference = .73 [95% confidence interval: -.81 to 2.27; I = 0%]). Narrative syntheses showed low-certainty evidence for improved knowledge and beliefs in children with preventative and treatment effects. Overall, we found few studies, and along with high risk of bias, this significantly contributed to the low certainty of findings. The effect of learning pain science for both preventative and treatment effects in children, carers, and the child/carer dyad remains mostly unknown. This review was prospectively registered with The international Prospective register of systematic reviews (CRD42022344382) on July 22, 2022. PERSPECTIVE: This review examines the effect of PSE on pain-related knowledge, beliefs, attitudes, and behaviors in children and the people that care for children (0-18). The findings contribute to knowledge about pain treatments and health promotion for caregivers and their children with and without chronic pain.

Ratings
Discipline Area Score
Psychologist 5 / 7
Physician 5 / 7
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Comments from MORE raters

Physician rater

As a family practitioner, I deal a lot with chronic pain in adults (not so much in kids). This review addresses a concept that is new to me, but I think clinically important. The review itself, however, is only minimally newsworthy given the low certainty of evidence. It won't affect my care or practice, but is definitely useful as a step toward guiding future research.

Physician rater

It is a good review to learn about pain management and the importance of patient education in improving the effectiveness of pain treatments. It affirms good practice that supports primary care practitioners known approaches of patient empowerment to better implement treatment plans.

Physician rater

Nice to know but the results do not influence practice.
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