Chronic pain: A systematic review of current treatment approaches and the impact on patient outcomes
Objective: To explore the effectiveness of treatment modalities considered alternative to opioid medication for non-malignant chronic pain.
Design: A systematic review of the literature was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines.
Methods: Seven treatment modalities were studied including cognitive behavioral therapy, physical therapy, yoga, meditation, chiropractic, acupuncture, and opioid therapy. Search databases included CINHAL, ProQuest, OVID, and Google Scholar. Search terms included chronic pain as well as each of the seven treatment modalities. Exclusion criteria included studies published before 2009 or not peer reviewed, pilot studies, dissertations, studies including children, and diagnoses such as fibromyalgia and rheumatoid arthritis. Study validity was determined using the United States Preventive Services Task Force (USPSTF) scoring system.
Results: A total of 3799 articles were identified in the initial search. After the exclusion criteria, 35 studies were deemed appropriate for analysis. Mean effect sizes were obtained from the data representing the efficacy of each of the seven modalities, and a meta-analysis was performed. Yoga had the largest effect size and, apart from opioids, was deemed to have the greatest impact on lowering pain scores. Meditation and cognitive behavioral therapy were shown to have a significant impact on reducing anxiety and depression, and improved quality of life.
Limitations: There was heterogeneity and publication bias noted. In addition, the study had one reviewer thereby reducing the scientific validity of results.
Conclusion: Alternative pain treatment modalities can have a significant effect on pain outcomes and help reduce the use of opioids.
This work has been approved through a faculty review process prior to its posting in the Virginia Henderson Global Nursing e-Repository.
| Type | DNP Capstone Project |
| Acquisition | Self-submission |
| Review Type | None: Degree-based Submission |
| Format | Text-based Document |
| Evidence Level | Systematic Review |
| Research Approach | Other |
| Keywords | Chronic Pain; Yoga; Acupuncture; Chiropractic; Physical Therapy; Meditation; Opioids; Cognitive Behavioral Therapy (CBT) |
| CINAHL Subject(s) | Alternative Therapies; Chronic Pain; Chronic Pain--Therapy |
| MESH Subject(s) | Patient Outcome Assessment |
| MESH Subject(s) | Patient Outcome Assessment |
| Grantor | Capella University |
| Advisor | Nogueras, Debra J.; Hayhurst, Janet; Farrell, Eileen |
| Level | DNP |
| Year | 2015 |
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