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Table 1 Characteristics of Included studies

From: Effects of education to facilitate knowledge about chronic pain for adults: a systematic review with meta-analysis

Author (year) in chronological order Specialty Patient eligibility and recruitment Trial characteristics Participant characteristics Intervention and follow-up periods Outcome measures reported
Studies assessing education versus usual care
Linton et al. 1997. Orebro (Sweden) Chronic back pain Age 18-60yrs old, accumulated sick leave for MSK pain of 2–24 weeks in the past year. Recruited via screening of insurance files, and through adverts in local newspaper Parallel design, three arms (two interventions: “Educational support”, and “Professional support”, one control - we are not including “Professional support”). “Educational support”: patient-based support group with education, insight and empathy, used mastering pain self-help book. “Control”: regular treatment group, no additional effort to facilitate or prohibit. “Educational support” n = 39 (74 % F), pain duration average 26 months; “Control” n = 25 (68 % F), pain duration average 26 months “Educational support”: met for 180 min 15 times in 1 year; once/week for a month, every 2 weeks for 3 months, every other month for 5 months. Outcome measures at baseline and 1 year later Sickness impact profile (SIP-pain), 50-item coping strategies questionnaire (CSQ), multidimensional pain inventory (MPI).
Attendance, outcome evaluation questionnaire, sick leave from work. three pain beliefs and attitudes: pain and impairment relationship scale (PAIRS), Pain and discomfort scale (PADS), pain beliefs and perceptions inventory (PBPI)
Soares et al. 2002. Stockholm (Sweden) Fibromyalgia FM diagnosed in previous 2 years, female, 18–64 years, no other serious illness, no ongoing drug/alcohol abuse, not involved in other therapies. Recruited via GPs working in Stockholm area. Parallel design, three arms (two interventions: “educational intervention” and “behavioural intervention”, one control - we are not including behavioural intervention). “educational intervention”: focus was on information about various health related topics inc the body, FM, pain, sleep hygiene, medication, managing crises, ergonomic education, self-management All female, “educational intervention” n = 18, mean age 47 years, pain duration 50 months, “wait list control” n = 17 mean age 43 years, pain duration 37 months “Education intervention”: two individual sessions (2 h each) and 15 group sessions (2 h each, 3–5 patients per group) for 10 weeks (total 102 h). Outcome measures at baseline, post-intervention, and 6 months later. The pain questionnaire (PQ), the arthritis self-efficacy scale (ASES), The McGill Pain Questionnaire (MPQ), The coping strategies Questionnaire (CSQ), The Karolinska Sleep Questionnaire (KSQ), “The Diary” VAS-pain
The Fibromyalgia Impact Questionnaire (FIQ), The symptom checklist - revised (SCL-90-R), The Interview Schedule of Social Support (ISSI),
Ruehlman et al. 2012. Arizona (USA) Chronic pain Over 18 yrs old, chronic pain for 6 months or more, access to computer with high speed internet, English language fluency. Recruitment via online pain sites. Parallel design, two arms (intervention: online Chronic Pain Management Program, control: wait-list/usual care). “CPMP” has four learning modules of both online and offline activities (e.g. didactic and interactive material online, homework and self-monitoring offline), includes social networking component. total n = 305 (196 F, 109 M), age 19–78 years mean 45 years, pain over 2 yrs in 90 % of sample, “CPMP” n = 162, “control” n = 143 “CPMP” unsupervised access to website for 6 weeks i.e. self-directed and self-paced online program. Outcome measures at baseline, 7 weeks (i.e. post-intervention period), and at 14 weeks. Profile of Pain: Screen (PCP-S),
Centre for Epidemiological Studies Depression Scale (CES-D), Depression Anxiety and Stress Scale (DASS), pain knowledge, attitudes and beliefs: profile of pain extended assessment (PCP-EA), pain interference in functioning
Sparkes et al. 2012. Cardiff (UK) Low back pain Over 18yrs old, LBP with or without referral to the lower limbs, referred to spinal pain clinic by GP, English language fluency. Recruited via referrals sent to the spinal pain clinic. Parallel design, two arms (intervention: The Back Book, control: usual care/wait list control). “Back Book” n = 29 (13 M, 16 F) mean age 52 years, “control” n = 28 (11 M, 17 F) mean age 52 years “Back Book” posted a copy of the book whilst waiting to be seen by specialist as part of referral process. Asked not to read until they had completed initial questionnaires. No follow-up letters sent which may have encourage compliance. Outcome measures at baseline (posted questionnaires after screening for inclusion/exclusion), and follow-up (at patients’ initial SPC consultation). VAS-pain
Back Beliefs Questionnaire (BBQ), Fear-avoidance beliefs questionnaire - physical activity (FABQ -PA), Roland Morris Disability Questionnaire (RMDQ), VAS-understanding of the back book
Excluded from analysis due to inability to extract data (Morrison et al. 1988)
Morrison et al. 1988. British Colombia (Canada) chronic back pain All (non-adolescent) patients routinely admitted to the back pain program between November 1981 and May 1982 participated. Referrals made by GPs and specialists. Not a classic design—used sequential instead of concurrent assessment. Each group only assessed once. Attempted to strengthen study by repeated time sampling (collecting data for six different sets of patients, each with their own control group) Mean age 45 years (range 17–74 years), n = 120 (63 % F), no individual group stats six 3-h sessions over 2-, 3- or 6-week period: lectures and demonstrations of anatomy, physiology, body mechanics, posture, stress recognition and management, pain relief, physical exercise, and first aid techniques. Each group assessed only once; control at baseline, intervention group at the end. One year after completion, a random sample of intervention-ers (n = 28) re-assessed (physical function), and (n = 85) returned follow-up questionnaires Oswestry Pain Scale (OPS), education - use of correct body mechanics, and patient knowledge (15-item quiz). State Anxiety Inventory (SAI). Function - strength and mobility, self-reported exercise, RAND physical abilities scale
Author (year) in chronological order Specialty Patient eligibility and recruitment Trial characteristics Participant characteristics Intervention and follow-up periods Outcome measures reported
Ferrell et al. 1997. California (USA) chronic musculo-skeletal pain Over 65 years old, presence of lower extremity pain, use of analgesics, ambulatory without assistance, English language fluency. Recruited from a Veterans Admin Medical Centre in response to info brochure mailed to home address Parallel design, three arms (two intervention: “physical methods” and “walkers”, one control - we are not including the “walkers” intervention). “physical methods”: 90minute education session of non-drug interventions. “control”: attention control, received printed material with general info about pain and management Mean age 73 years, “physical methods” n = 10 (3 F, 7 M), pain duration 1–53 years; “control” n = 10 (10M), pain duration 10 months–53 years Two orientation sessions prior to intervention to educate about pain. ”physical methods” one-off education session. Outcomes measures at baseline (pre-randomisation; t1), following the two orientation sessions (t2), and 6 weeks later (t3) Patient Pain Questionnaire (PPQ), RAND 36-item health Survey (SF-36).
three performance tests: 6 min walk test, sit to stand 30, sit and reach test
Moseley et al. 2004. Brisbane and Sydney (Australia) Chronic low back pain Primary reason for presentation at pain clinic was LBP longer than 6 months. Recruited by A note advertising the project was included in the material given to patients at three private rehab clinics. Parallel design, two arms (intervention: neurophysiology education, control: back education) Intervention: “neurophysiology education” n = 31 (13 M, 18 F), mean age 42 years, pain duration average 29 months. Control “back education” n = 27 (12 M, 15 F), mean age 45 years, pain duration average 30 months Both groups same format: took part in a one-off education session in 1-to-1 seminar format, each session was 3 h long with a 20 min break. Homework was a workbook in ten sections - read one section, answer three questions each weekday for 2 weeks. Compliance. Roland Morris Disability Questionnaire (RMDQ). Survey of Pain Attitudes, revised (SOPA-R). Three physical performance measures - straight leg raise (SLR), forward bending range, abdominal drawing in task (ADIT), Pain Catastrophising Scale (PCS)
Gallagher et al. 2013. Adelaide and Sydney (Australia) Chronic pain Age 18–75 years, pain that disrupts ADLs for more than previous 3 months, English language fluency. Recruited from waiting list for multidisciplinary pain management program. Partial (control group) cross-over design, two arms (intervention: “book of metaphors to help understand the biology of pain”, control: “advice about managing pain”, then crossed over to intervention). “book of metaphors” each section was a short story, followed by interpretation. “control/ advice booklet” each section focussed on a concept of pain management and drew heavily from the back book and manage your pain. “metaphors” n = 40 (26 F, 14 M), age = 42 years, pain duration =25 months. “advice/control” n = 39 (22 F, 17 M), age = 45 years, pain duration = 31 months Both groups received information in the same format—booklet of 80 pages in 11 sections. Outcome measures at baseline, and emailed questionnaires 3 weeks later, and two months after that (“12 weeks”). Pain assessed on 11-point numerical rating scale (NRS),
pain biology questionnaire (PBQ), pain catastrophising scale (PCS), disability/function—Five tasks assessed on 11-point numerical rating scale (NRS)
Van Oosterwijck et al. 2013. Brussels (Belgium) and Glasgow (UK) Fibromyalgia Age 18–65 years, FM defined by the criteria of the 1990ACR, have Dutch as native language Parallel design, two arms (intervention: neurophysiology education, control: activity management education) Intervention “neurophysiology” n = 15 (3 M, 12 F) age = 46 years, symptom duration = 156 months. Control “activity management” n = 15 (1 M, 14 F) age = 46 years, symptom onset = 116 months 2 one-on-one education sessions. Intervention and control differed in content only. First session used powerpoint presentation of 30 min. Leaflet handed out. Second session 1 week later delivered by telephone. Outcome measures at baseline (pre), 2 weeks (post), and 3 months (follow-up). Additional outcome measure (PPT and neurophysiology questionnaire) also tested after first education session. Spatial summation procedure (SSP), Health status survey (SF36), pain coping inventory (PCI), Pain Vigilance and Awareness Questionnaire (PVAQ), Tampa Scale Kinaesiophobia (TSK), pressure pain threshold (PPT)
pain catastrophising scale (PCS), fibromyalgia impact questionnaire (FIQ), Neurophysiology of pain test