Niknejad B, et al. - The efficacy of psychological interventions in older adults with chronic pain was investigated. In addition, researchers determined if treatment effects vary by participant, intervention, and study characteristics. In older adults, psychological interventions for the treatment of chronic pain showed small benefits, including reducing pain and catastrophizing beliefs and improving pain self-efficacy for managing pain. When delivered using group-based approaches, these results were strongest.

Methods

• A search of MEDLINE, Embase, PsycINFO, and the Cochrane Library from inception to March 29, 2017 was performed for the data.
• For analysis, included studies were those which
• (1) Used a randomized trial design,
• (2) Evaluated a psychological intervention that used cognitive behavioral modalities alone or in combination with another strategy,
• (3) Enrolled individuals with chronic pain (pain ≥3 months) with a sample mean age of 60 years or older, and
• (4) Reported preintervention and postintervention quantitative data.
• Data was independently extracted by 2 authors.
• The effects of treatment on outcomes was assessed via a mixed-model meta-analysis.
• The association between participant (eg, age), intervention (eg, treatment mode delivery), and study (eg, methodologic quality) characteristics with outcomes was investigated via performing analyses.
• The primary outcome included pain intensity.
• Secondary outcomes included pain interference, depressive symptoms, anxiety, catastrophizing beliefs, self-efficacy for managing pain, physical function, and physical health.

Results

• Analysis of 22 studies with 2,608 participants (1,799 [69.0%] women) was performed.
• Mean (SD) age of the participants was 71.9 (7.1) years.
• In this study, differences of standardized mean differences (d_D) at posttreatment were pain intensity (d_D = -0.181, P=.006), pain interference (d_D = -0.133, P=.12), depressive symptoms (d_D = -0.128, P=.14), anxiety (d_D = -0.205, P=.09), catastrophizing beliefs (d_D = -0.184, P=.046), self-efficacy (d_D = 0.193, P=.02), physical function (d_D = 0.006, P=.96), and physical health (d_D= 0.160, P=.24).
• Observation suggested persistence of effects beyond the posttreatment assessment only for pain (d_D = -0.251, P=.002).
• Moderator analyses revealed that only mode of therapy (group vs individual) had a consistent effect in favor of group-based therapy.