A Systematic Review of Randomized Controlled Trials Examining Psychological Interventions for Needle-related Procedural Pain and Distress in Children and Adolescents: An Abbreviated Cochrane Review

BackgroundApproximately 15 to 30% of children and adolescents suffer from daily pain persistent over more than 3 months and there is evidence supporting that the prevalence of chronic pain is steadily increasing in this population. Chronic pain is known to have a negative impact on children's development and social behaviour, leading often to severe psychological distress and physical disability. We reviewed medical literature to assess the characteristics and quality of randomized controlled trials (RCTs) on pharmacological and non-pharmacological therapies in chronic and recurrent pain in the paediatric population.MethodsWe performed a systematic search of PubMed, Embase and the Cochrane Library up to March 2014. Bibliographies of relevant articles were also hand-searched. We included all RCTs that involved children and adolescents (age 0 to 18 years) and evaluated the use of a pharmacological agent or a non-pharmacological approach in the context of chronic or recurrent pain. The latter was defined as pain persisting for more than 3 months. Methodological quality was evaluated using the Cochrane Risk of Bias Tool. Two reviewers independently assessed studies for inclusion and evaluated methodological quality.ResultsA total of 52 randomized controlled trials were selected and included in the analysis. The majority were conducted in single hospital institutions, with no information on study funding. Median sample size was 45 (34–57) participants. Almost 50% of the RCTs included both adults and children with a median age at inclusion of 13 years. Non-pharmacological approaches were more commonly tested whereas evaluation of pharmacological agents concerned less than 30% of RCTs. Abdominal pain and headache were the most common types of chronic pain experienced among trial participants. Overall, the methodological quality was poor and did not parallel the number of RCTs that increased over the years. The risk of bias was high or unclear in 70% of the trials.ConclusionsThis is the first systematic review of RCTs conducted to evaluate pharmacological and non-pharmacological therapies in chronic and recurrent pain in children and adolescents. Although, management of pain in adults has significantly improved over the years due to the evaluation of numerous analgesic therapies, our results highlight the existing knowledge gap with regards to children and adolescents. Therapeutic strategies, in particular pharmacological agents, applied to relieve chronic or recurrent pain in children and adolescents are not evaluated through high quality RCTs. The need to improve analgesic therapy in children and adolescents with chronic pain is still unmet. We discuss possible research constraints and challenges related to this fact as well as adequate methodologies to circumvent them.

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M103. PSYCHOLOGICAL ONLINE INTERVENTION FOR PSYCHOSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa030.415 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S174-S174

Author(s):

Rebeca Pardo Cebrián ◽

Eduardo González-Fraile ◽

Teresa Sánchez-Gutiérrez ◽

Sara Barbeito ◽

Belén Fernández-Castilla ◽

...

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Randomised Trial ◽

Online Intervention ◽

Well Being ◽

Psychotic Symptoms ◽

Psychological Interventions ◽

Controlled Trials ◽

Randomized Controlled

Abstract Background Although the use of technological advances in psychiatric treatment is relatively recent, the availability and sophistication of technologies are growing, research on psychological interventions for patients with psychosis has incorporated the use of various electronic applications, social networks, and other similar tools to provide new methods/routes of communication between therapists and patients. This new therapeutic approach may provide patients with personalized, flexible, and evidence-based interventions in their communities and even in their own homes. The aim of this study is reviewing the scientific literature about the use of online intervention for patients with psychosis to show the current state of online intervention and asses the effectiveness of these treatments. Methods The review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We have identified articles from Pubmed and Medline databases. We included all randomized controlled trials designed to test the efficacy of the online intervention or web-based intervention to patients with psychosis. We excluded observational trials, non-randomised trial and protocol study. Studies with RCT design and the participants must not have more than 5 to 10 years of evolution since the diagnosis, and the papers have been published between 2010 and 2019, in English language. The researchers independently assessed the articles and the discrepancies were resolved by consensus. Results We presented data about all randomized controlled trials of online interventions/ e-Health interventions/ App-mobile based and/or computer based intervention programs than were specifically designed for people with first episode psychosis or psychotic symptoms that had measured changes in functioning, quality of life or positive/negative symptoms. As unique treatment or as a complementary treatment with other psychological or psychopharmacology intervention. Discussion Online psychological interventions can play an important role in the well-being of people with schizophrenia. The strengths and limitations of our systematic review and meta-analysis will be discussed.

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