Psychosocial approach useful in managing cancer pain

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Psychosocial interventions, including skills instruction and education, can help reduce pain in persons with cancer, confirm the results of a recent meta-analysis.

To obtain a current, stable, and comprehensive estimate of the effect of psychosocial interventions on pain, Paul B. Jacobsen, PhD, of the H. Lee Moffitt Cancer Center in Tampa, Florida, and colleagues conducted a meta-analysis of randomized controlled studies of cancer-related pain reduction in adults. The trials had been published between 1966 and 2010.

Of 1,681 abstracts reviewed, 37 papers involving a total of 4,199 study participants were found to contain sufficient data for meta-analysis. The investigators used pain severity and pain interference with daily activities as primary outcome measures.

Psychosocial interventions were found to have medium-size effects on both pain severity and pain interference. Studies that monitored whether treatment was delivered as intended had larger effects than those that did not.

The most successful psychosocial, nonpharmacologic pain interventions were either skill-based or educational: Skill-based approaches centered on changing the ways in which patients interpreted pain and using such techniques as distraction or relaxation to manage pain, and educational strategies provided instruction on how to better use medications or how to communicate with clinicians more effectively about unrelieved pain.

“These robust findings support the systematic implementation of quality-controlled psychosocial interventions as part of a multimodal approach to the management of pain in patients with cancer,” concluded the authors in their Journal of Clinical Oncology report.

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