A systematic review of in‐person versus remotely delivered interventions for youth with chronic pain

Nicole E. MacKenzie, M. Marbil, Sabine Soltani, Diane L. Lorenzetti, K. Birnie
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Abstract

The COVID‐19 pandemic prompted a rapid shift from in‐person to virtually‐delivered care. Many youth with chronic pain have the ability to access care virtually; however, little is known about the efficacy of pain care for youth with chronic pain delivered virtually when compared to in‐person. Such evidence is essential to guide youth in making decisions about their care, but also to inform what options health professionals present to youth. The purpose of this systematic review and meta‐analysis was to examine the efficacy of interventions that are delivered in‐person versus virtually for youth with chronic pain. Five databases (i.e., CINAHL, EMBASE, MEDLINE, APA PsycINFO, and Web of Science) were searched in October 2022 to identify randomized controlled trials that compare single/multimodal interventions for pediatric chronic pain delivered in‐person versus virtually. A total 3638 unique studies were identified through database and other searching, two of which satisfied established criteria for inclusion in this review. Both studies compared psychological interventions delivered virtually versus in‐person for youth with chronic pain and showed comparable efficacy across modalities. The planned meta‐analyses could not be conducted due to different outcomes within each study that could not be combined. This systematic review highlights a critical gap in the evidence regarding the efficacy of virtually delivered interventions for youth with chronic pain. This evidence is necessary to inform treatment decisions for youth, and further research is required to develop the evidence to inform clinical interventions, especially as virtual treatments continue to be offered.
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针对慢性疼痛青少年的面对面干预与远程干预的系统性审查
COVID-19 大流行促使人们迅速从面对面护理转变为虚拟护理。许多患有慢性疼痛的青少年有能力通过虚拟方式获得治疗;然而,与面对面治疗相比,人们对通过虚拟方式为患有慢性疼痛的青少年提供疼痛治疗的效果知之甚少。这些证据对于指导青少年做出治疗决定至关重要,同时也能为医疗专业人员向青少年提供哪些选择提供依据。本系统综述和荟萃分析的目的是研究针对慢性疼痛青少年的面对面干预与虚拟干预的疗效。研究人员于 2022 年 10 月检索了五个数据库(即 CINAHL、EMBASE、MEDLINE、APA PsycINFO 和 Web of Science),以确定比较面对面与虚拟方式对儿科慢性疼痛进行单一/多模式干预的随机对照试验。通过数据库和其他检索,共发现了 3638 项独特的研究,其中两项符合纳入本综述的既定标准。这两项研究比较了针对患有慢性疼痛的青少年的虚拟和面对面心理干预,结果显示不同模式的疗效相当。由于每项研究的结果不同,无法合并,因此无法进行计划中的荟萃分析。本系统综述强调了在针对慢性疼痛青少年的虚拟干预疗效方面存在的重要证据缺口。这些证据对于为青少年的治疗决策提供依据是非常必要的,而且还需要进一步的研究来开发证据,为临床干预提供依据,尤其是随着虚拟治疗的不断推出。
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