Non-pharmacological and non-invasive interventions for chronic pain in people with Chronic Obstructive Pulmonary Disease: A Systematic Review without Meta-analysis

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Abstract

Objectives
Chronic Obstructive Pulmonary Disease (COPD) is complicated by chronic pain. People with COPD report higher pain prevalence than the general population. Despite this, chronic pain management is not reflected in current COPD clinical guidelines and pharmacological treatments are often ineffective. We conducted a systematic review that aimed to establish the efficacy of existing non-pharmacological and non-invasive interventions on pain and identify behaviour change techniques (BCTs) associated with effective pain management.

Methods
A systematic review was conducted with reference to Preferred Reporting Items for Systematic Review (PRISMA) (Page, et al., 2021), Systematic review without Meta analysis (SWIM) standards (Campbell et al., 2020) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines (Guyatt, et al., 2008). We searched 14 electronic databases for controlled trials of non-pharmacological and non-invasive interventions where the outcome measure assessed pain or contained a pain subscale.

Results
Twenty-nine studies were identified involving 3,228 participants. Seven interventions reported a minimally important clinical difference in pain outcomes, although only two of these reached statistical significance (p
Conclusions
Pain appears to be a meaningful issue for many individuals with COPD. However, intervention heterogeneity and issues with methodological quality limit certainty about the effectiveness of currently available non-pharmacological interventions. An improvement in reporting is required to enable identification of active intervention ingredients associated with effective pain management.

Original languageEnglish
Article number107191
Number of pages22
JournalRespiratory Medicine
Volume211
Early online date6 Mar 2023
DOIs
Publication statusPublished - 1 May 2023

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