Aggarwal, VR orcid.org/0000-0003-0838-9682, Fu, Y orcid.org/0000-0003-4972-0626, Main, CJ et al. (1 more author) (2019) The effectiveness of self-management interventions in adults with chronic orofacial pain: A systematic review, Meta-analysis and Meta-regression. European Journal of Pain, 23 (5). pp. 849-865. ISSN 1090-3801
Abstract
Background: Psychosocial risk factors associated with chronic orofacial pain are amenable to self‐management. However, current management involves invasive therapies which lack an evidence base and have the potential to cause iatrogenic harm.
Objectives: To determine: 1) whether self‐management is more effective than usual care in improving pain intensity and psychosocial well‐being 2) optimal components of self‐management interventions.
Databases and Data treatment: Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PsycINFO, WHO International Clinical Trials Registry Platform and Clinical Trialsgov were searched. Meta‐analysis was used to determine effectiveness and GRADE was used to rate quality, certainty and applicability of evidence.
Results: Fourteen trials were included. Meta‐analyses showed self‐management was effective for long‐term pain intensity (standardised mean difference (SMD) ‐0.32, 95% confidence interval (CI) ‐0.47 to ‐0.17) and depression (SMD ‐0.32, 95% CI ‐0.50 to ‐0.15). GRADE analysis showed a high score for certainty of evidence for these outcomes and significant effects for additional outcomes of activity interference (‐0.29 95% CI ‐0.47 to ‐ 0.11) and muscle palpation pain (SMD ‐0.58 95% CI ‐0.92 to ‐0.24).
Meta‐regression showed non‐significant effects for biofeedback on long‐term pain (‐0.16, 95% CI ‐0.48 to 0.17, P‐value = 0.360) and depression (‐0.13, 95% CI ‐0.50 to 0.23, P‐value = 0.475).
Conclusions: Self‐management interventions are effective for patients with chronic orofacial pain. Packages of physical and psychosocial self‐regulation and education appear beneficial. Early self‐management of chronic orofacial pain should be a priority for future testing.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | This article is protected by copyright. All rights reserved. This is the peer reviewed version of the following article: Aggarwal, VR , Fu, Y, Main, CJ et al. (1 more author) (2019) The effectiveness of self-management interventions in adults with chronic orofacial pain: A systematic review, Meta-analysis and Meta-regression. European Journal of Pain. ISSN 1090-3801, which has been published in final form at https://doi.org/10.1002/ejp.1358. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Dentistry (Leeds) > Applied Health and Clinical Translation (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Dentistry (Leeds) > Dentistry (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Healthcare (Leeds) > Midwifery (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 07 Jan 2019 17:12 |
Last Modified: | 08 Jan 2020 01:39 |
Status: | Published |
Publisher: | Wiley |
Identification Number: | 10.1002/ejp.1358 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:140569 |