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Efficacy of Online-Based Acceptance and Commitment Therapy for Chronic Pain : A Systematic Review and Meta-Analysis

Trindade, Inês A. ; Guiomar, Raquel ; Carvalho, Sérgio A. ; Duarte, Joana LU ; Lapa, Teresa ; Menezes, Paulo ; Nogueira, Maria Rita ; Patrão, Bruno ; Pinto-Gouveia, José and Castilho, Paula (2021) In Journal of Pain 22(11). p.1328-1342
Abstract

Acceptance and Commitment Therapy (ACT) has been widely tested for chronic pain, with demonstrated efficacy. Nevertheless, although there is meta-analytical evidence on the efficacy of face-to-face ACT, no reviews have been performed on online ACT in this population. The aim of this meta-analysis is to determine the efficacy of online ACT for adults with chronic pain, when compared with controls. PubMed, PsycINFO, CENTRAL, and Web of Knowledge were searched for randomized controlled trials (RCTs) of online-delivered ACT for chronic pain. Effects were analyzed at post-treatment and follow-up, by calculating standardized mean differences. Online-delivered ACT was generally favored over controls (5 RCTs, N = 746). At post-treatment, medium... (More)

Acceptance and Commitment Therapy (ACT) has been widely tested for chronic pain, with demonstrated efficacy. Nevertheless, although there is meta-analytical evidence on the efficacy of face-to-face ACT, no reviews have been performed on online ACT in this population. The aim of this meta-analysis is to determine the efficacy of online ACT for adults with chronic pain, when compared with controls. PubMed, PsycINFO, CENTRAL, and Web of Knowledge were searched for randomized controlled trials (RCTs) of online-delivered ACT for chronic pain. Effects were analyzed at post-treatment and follow-up, by calculating standardized mean differences. Online-delivered ACT was generally favored over controls (5 RCTs, N = 746). At post-treatment, medium effects for pain interference and pain acceptance, and small effects for depression, mindfulness, and psychological flexibility were found. A medium effect for pain interference and acceptance, and small effects for pain intensity, depression, anxiety, mindfulness, and psychological flexibility were found at follow-up. ACT-related effects for pain interference, pain intensity, mindfulness, and anxiety increased from post-treatment to follow-up. Nevertheless, the current findings also highlight the need for more methodologically robust RCTs. Future trials should compare online ACT with active treatments, and use measurement methods with low bias. Perspective: This is the first meta-analytical review on the efficacy of online ACT for people with chronic pain. It comprises 5 RCTs that compared online ACT with active and/or inactive controls. Online ACT was more efficacious than controls regarding pain interference, pain intensity, depression, anxiety, mindfulness, and psychological flexibility.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Acceptance and Commitment Therapy, Chronic pain, Meta-analysis, Online-delivered ACT, Systematic review
in
Journal of Pain
volume
22
issue
11
pages
1328 - 1342
publisher
Elsevier
external identifiers
  • pmid:33892153
  • scopus:85106564028
ISSN
1526-5900
DOI
10.1016/j.jpain.2021.04.003
language
English
LU publication?
yes
id
0e5a3316-e3fa-48a2-975d-c316c0b1b16a
date added to LUP
2021-06-14 11:29:57
date last changed
2024-07-14 16:31:02
@article{0e5a3316-e3fa-48a2-975d-c316c0b1b16a,
  abstract     = {{<p>Acceptance and Commitment Therapy (ACT) has been widely tested for chronic pain, with demonstrated efficacy. Nevertheless, although there is meta-analytical evidence on the efficacy of face-to-face ACT, no reviews have been performed on online ACT in this population. The aim of this meta-analysis is to determine the efficacy of online ACT for adults with chronic pain, when compared with controls. PubMed, PsycINFO, CENTRAL, and Web of Knowledge were searched for randomized controlled trials (RCTs) of online-delivered ACT for chronic pain. Effects were analyzed at post-treatment and follow-up, by calculating standardized mean differences. Online-delivered ACT was generally favored over controls (5 RCTs, N = 746). At post-treatment, medium effects for pain interference and pain acceptance, and small effects for depression, mindfulness, and psychological flexibility were found. A medium effect for pain interference and acceptance, and small effects for pain intensity, depression, anxiety, mindfulness, and psychological flexibility were found at follow-up. ACT-related effects for pain interference, pain intensity, mindfulness, and anxiety increased from post-treatment to follow-up. Nevertheless, the current findings also highlight the need for more methodologically robust RCTs. Future trials should compare online ACT with active treatments, and use measurement methods with low bias. Perspective: This is the first meta-analytical review on the efficacy of online ACT for people with chronic pain. It comprises 5 RCTs that compared online ACT with active and/or inactive controls. Online ACT was more efficacious than controls regarding pain interference, pain intensity, depression, anxiety, mindfulness, and psychological flexibility.</p>}},
  author       = {{Trindade, Inês A. and Guiomar, Raquel and Carvalho, Sérgio A. and Duarte, Joana and Lapa, Teresa and Menezes, Paulo and Nogueira, Maria Rita and Patrão, Bruno and Pinto-Gouveia, José and Castilho, Paula}},
  issn         = {{1526-5900}},
  keywords     = {{Acceptance and Commitment Therapy; Chronic pain; Meta-analysis; Online-delivered ACT; Systematic review}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{1328--1342}},
  publisher    = {{Elsevier}},
  series       = {{Journal of Pain}},
  title        = {{Efficacy of Online-Based Acceptance and Commitment Therapy for Chronic Pain : A Systematic Review and Meta-Analysis}},
  url          = {{http://dx.doi.org/10.1016/j.jpain.2021.04.003}},
  doi          = {{10.1016/j.jpain.2021.04.003}},
  volume       = {{22}},
  year         = {{2021}},
}