Aggarwal, VR, Fu, Y, Main, CJ and Wu, J (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 1532-2149

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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. This article is protected by copyright. All rights reserved.

Item Type: Article
Additional Information: The final published version of this article is available online at https://onlinelibrary.wiley.com/doi/abs/10.1002/ejp.1358
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
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Depositing User: Symplectic
Date Deposited: 29 Jan 2019 11:00
Last Modified: 29 Jan 2019 11:00
URI: http://eprints.keele.ac.uk/id/eprint/5725

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