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Review
. 2012 Feb 10;30(5):539-47.
doi: 10.1200/JCO.2011.37.0437. Epub 2012 Jan 17.

Meta-analysis of psychosocial interventions to reduce pain in patients with cancer

Sherri Sheinfeld Gorin  1 , Paul Krebs, Hoda Badr, Elizabeth Amy Janke, Heather S L Jim, Bonnie Spring, David C Mohr, Mark A Berendsen, Paul B Jacobsen
Affiliations
Review

Meta-analysis of psychosocial interventions to reduce pain in patients with cancer

Sherri Sheinfeld Gorin et al. J Clin Oncol. .

Abstract

Purpose: Pain is one of the most common, burdensome, and feared symptoms experienced by patients with cancer. American Pain Society standards for pain management in cancer recommend both pharmacologic and psychosocial approaches. To obtain a current, stable, and comprehensive estimate of the effect of psychosocial interventions on pain-an important clinical topic-we conducted a meta-analysis of randomized controlled studies among adult patients with cancer published between 1966 and 2010.

Methods: Three pairs of raters independently reviewed 1,681 abstracts, with a systematic process for reconciling disagreement, yielding 42 papers, of which 37 had sufficient data for meta-analysis. Studies were assessed for quality using a modified seven-item Physiotherapy Evidence Database (PEDro) coding scheme. Pain severity and interference were primary outcome measures.

Results: Study participants (N = 4,199) were primarily women (66%) and white (72%). The weighted averaged effect size across studies for pain severity (38 comparisons) was 0.34 (95% CI, 0.23 to 0.46; P < .001), and the effect size for pain interference (four comparisons) was 0.40 (95% CI, 0.21 to 0.60; P < .001). Studies that monitored whether treatment was delivered as intended had larger effects than those that did not (P = .04).

Conclusion: Psychosocial interventions had medium-size effects on both pain severity and interference. These robust findings support the systematic implementation of quality-controlled psychosocial interventions as part of a multimodal approach to the management of pain in patients with cancer.

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Conflict of interest statement

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

Figures

Fig 1.
Fig 1.
Selection of included studies.
Fig 2.
Fig 2.
Forest plot of effect sizes (g) for studies measuring pain severity (k = 38).
Fig 3.
Fig 3.
Funnel plot of effect sizes by standard error for pain severity.
See this image and copyright information in PMC

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MeSH terms