Table 2.
Summary of Included Studies
| Author/year | Description of study participants | Setting | Patient-reported pain outcomes: mean change from baseline (effect size) | Description of intervention(s) | Study quality |
|---|---|---|---|---|---|
| Aragaonés 201938 | Adult patients (18–80 years) experiencing major depressive episode and moderate to severe musculoskeletal pain (n = 328) | 8 urban primary care centers |
BPI Pain severity: − 0.22 (0.17) Pain interference: − 1.44* (0.22) |
DROP (Depression and Pain Program): optimized management of major depression, care management, psycho-educational program | Good |
| Bair 201510† | Veterans (≥ 18 years) with self-reported chronic musculoskeletal pain (n = 241) | 5 general medicine clinics and 1 post-deployment clinic within single VA medical center |
BPI Pain interference: − 1.7* (0.26) GCPS Pain severity: − 11.1 (0.21) RMDQ Pain-related disability − 3.4* (0.23) |
ESCAPE Intervention: stepped care (optimization of analgesic therapy followed by CBT program) | Good |
| Bruhn 201339 | Adults (≥ 18 years) receiving regularly prescribed medication for pain (n = 193) | 6 general practice clinics |
Intervention 1 GCPS Pain intensity: − 8.0 (0.38) Pain-related disability: − 20.0 |
Intervention 1 Pharmacist prescribing and review: Pharmacist consults patient in person for medication review and develops a treatment plan |
Fair |
|
Intervention 2 GCPS Pain intensity: − 1.0 (0.14) Pain-related disability: − 13.4 |
Intervention 2 Pharmacist review: pharmacist medication + treatment review to create treatment plan for GP |
Fair | |||
| Clark 201548 | Adults (≥ 18 years) with chronic neurological or musculoskeletal pain | Chronic pain center |
NRS Average pain: − 0.96 Worst pain: − 0.38 Least pain: − 0.92 Current pain: − 0.83 PDI Pain-related disability: − 4.73 |
Standard telephone consultation: telehealth management via pain specialist to assist PCP with best pain management practices | Fair |
| Dobscha 20099 | Adults (≥ 18 years) with musculoskeletal pain diagnoses (n = 401) | 5 primary care clinics within single VA Medical Center |
GCPS Pain intensity: − 4.7 (0.17) Pain interference: − 5.7 (0.32) RMDQ Pain-related disability: − 1.4 (0.26) |
SEACAP: a collaborative care management team developed treatment recommendations for the patient’s PCP and delivered a 4-session pain workshop to the patients | Good |
| Gardiner 201940† | Low-income racially diverse adults (≥ 18 years) with non-specific chronic pain and depressive symptoms (n = 155) | 1 academic tertiary hospital and 2 affiliated community health centers |
BPI Pain interference: − 1.0* (0.00) Pain severity: − 1.0* (0.39) Average pain: − 1.0* (0.00) |
Integrative group medical visits: 10 in-person weekly group visits followed by 12 weeks self-management via online platform |
Good |
| Goertz 201741† | Community dwelling, ambulatory adults (65 years) who were experiencing a chronic LBP episode (n = 131) | Clinics of a family medicine residency and a chiropractic research center |
NRS Average pain: − 1.8 (0.18) Worst pain: − 2.1* (0.06) RMDQ Pain-related disability: − 2.8 (0.37) |
Shared care: 12 weeks of LBP-guideline-based care and individualized chiropractic care, shared treatment plan | Good |
| Helminen 201542 |
Adults (35–75 years) with clinical symptoms of knee osteoarthritis (n = 111) |
Primary care providers from multiple clinics in Finland |
WOMAC Pain: − 22.0* (0.18) NRS Average pain in last week: − 1.6 (0.04) Worst pain in last week: − 2.1* (0.30) Average pain in last 3 months: − 1.6 (0.90) Worst pain in last 3 months: − 1.8 (0.68) SF-36 Bodily pain: − 6.3 (0.05) |
Cognitive behavioral group intervention: Groups of 8–10 individuals participated in six cognitive behavioral group sessions | Fair |
| Kroenke 200943† | Adults (≥ 18 years) experiencing comorbid musculoskeletal pain and depression | 2 primary care clinical systems (6 community-based clinical sites ad 5 general medicine clinics) |
BPI Pain severity: − 1.08* (0.54) Pain interference: − 1.88* (0.62) Total pain: − 1.68* GCPS Pain severity: − 4.9 (0.32) Pain-related disability: − 15.3 (0.46) RMDQ Pain-related disability: − 3.3* (0.54) SF-36 Bodily pain: − 10.8* (0.44) |
SCAMP: stepped care for affective disorders and musculoskeletal pain; optimized antidepressant therapy followed by pain self-management program, relapse prevention | Good |
| Kroenke 201444 |
Adults (18–65 years) experiencing chronic regional or localized musculoskeletal pain (n = 250) |
5 primary care clinics within single VA medical center |
BPI Total pain: − 1.74* (0.57) Pain severity: − 1.47* (0.40) Pain interference: − 2.01* (0.51) |
SCOPE: optimized analgesic management through a telecare collaboration supported by patient ASM | Good |
| Kroenke 201945† | Adult patients (≥ 18 years) with localized musculoskeletal pain or widespread fibromyalgia plus psychiatric comorbidity (n = 294) | 6 primary care clinics within single VA Medical Center |
BPI Total pain: − 1.0* (0.01) SF-36 Bodily pain: − 5.1 (0.08) |
CAMMPS: Comprehensive symptom management enhanced with ASM | Good |
| Lambeek 201046 | Adults (18–65 years) with low back pain and at least partially absent from work (n = 134) | 10 physiotherapy practices, 1 occupational health service, and 5 hospitals |
VAS Pain intensity: − 0.53 (0.10) |
Integrated care: composed of workplace intervention and graded activity program coordinated by integrated care team | Good |
All pain scales are defined in Table 1
Abbreviations: DROP Depression and Pain Program, PCP primary care provider, ESCAPE Evaluation of Stepped Care for Chronic Pain, CBT cognitive behavioral therapy, GP general practitioner, SEACAP Study of the Effectiveness of a Collaborative Approach to Pain, CIH complementary integrated health, LBP low back pain, OA osteoarthritis, SCAMP Stepped Care for Affective Disorders and Musculoskeletal Pain, NCM nurse care manager, SCOPE Stepped Care to Optimize Pain Care Effectiveness, CAMMPS Comprehensive vs. Assisted Management of Mood and Pain Symptoms
*Mean difference ≥ than defined MCID for pain scale
†Control differed slightly from treatment as usual