An evaluation of the effectiveness of the modalities used to deliver eHealth interventions for Chronic Pain: A systematic review with network meta-analysis. (Preprint) [post]

Brian W. Slattery, Stephanie Haugh, Laura O'Connor, Kady Francis, Christopher P. Dwyer, Siobhan O'Higgins, Jonathan Egan, Brian E. McGuire
2018 unpublished
BACKGROUND eHealth is the use of information and communication technology in the context of healthcare and health research. Recently, there has been a rise in the number of eHealth modalities and the frequency in which they are used to deliver technology-assisted self-management interventions for people living with chronic pain. However, there has been little or no research directly comparing these eHealth modalities. OBJECTIVE The aim of the current systematic review with a network
more » ... s is to directly compare the effectiveness of eHealth modalities in the context of chronic pain. METHODS Randomised controlled trials (N>20 per arm) that investigated technologically delivered interventions for adults with chronic pain were included. Data were extracted on pain severity, psychological distress and HRQoL, and the risk of bias was assessed. Studies were classified by their primary mode of delivery. Pair-wise meta-analyses were undertaken and a network meta-analysis was conducted to generate indirect comparisons of modalities for reducing pain severity. RESULTS The search returned 18,470 studies with 18,349 excluded (duplicates [2,310]; title and abstract [16,039]). Of the remaining papers, 30 studies with 4,595 randomised participants were included in the review. Rankings tentatively indicate that telephone supported interventions are the most effective, with a 46% chance that telephone intervention was the best modality, followed by studies delivered via interactive voice response, internet and virtual reality. CONCLUSIONS This current systematic review with a network meta-analysis generated comparisons between previously un-compared technological modalities to determine which delivered the most effective interventions for the reduction of pain severity in chronic pain patients. There are limitations with this review; in particular, the underrepresented nature of some eHealth modalities included in the analysis. However, in the event that the review is regularly updated a clear ranking of eHealth modalities for the reduction of pain severity will emerge. CLINICALTRIAL PROSPERO: Registration database number: CRD42016035595
doi:10.2196/preprints.11086 fatcat:v4lsd6npazdnpclgyc2nd3eqoq