Remotely delivered psych therapies: limited evidence for pediatric benefit

  • Fisher E & al.
  • Cochrane Database Syst Rev
  • 2 Apr 2019

  • International Clinical Digest
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Takeaway

  • Remotely delivered psychological therapies for chronic pain and other conditions have limited evidence supporting their benefits, according to the results of this Cochrane review.
  • The authors report possible benefit of reduced headache severity; for other outcomes, they found lack of evidence of effect or no benefit.

Why this matters

  • This review updates a 2015 version with new studies but unchanged conclusions.
  • Remote delivery of these interventions had been held as a promising way to reduce barriers to care.

Key results

  • In a total of 10 studies assessing remote delivery of treatment for chronic pain (e.g., headache, abdominal pain), some biases were low risk, but performance and attrition biases were unclear.
  • For headache, posttreatment severity was reduced (7 studies; n=379; very low-quality evidence):
    • Risk ratio, 2.02 (95% CI, 1.35-3.01; P<.001>
    • Number needed to treat to benefit: 5.36.
  • No effect seen at follow-up, however.
  • No effects seen for disability, depression, anxiety, mixed chronic pain conditions.
  • Adverse events were limited and minor.

Study design

  • Meta-analysis of 10 studies (4 since last publication), 697 participants.
  • Outcomes at the end of treatment and follow-up of 3-12 months.
  • Funding: NIH. 

Limitations

  • Limitations are those of the included studies.

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