The following is a summary of “Non-pharmacological and non-invasive interventions for chronic pain in people with chronic obstructive pulmonary disease: A systematic review without meta-analysis,” published in the MAY 2023 issue of Pulmonology by Morris, et al.

The presence of chronic pain further complicates Chronic Obstructive Pulmonary Disease (COPD) in affected individuals, with higher pain prevalence reported among them compared to the general population. Despite this, current clinical guidelines for COPD do not include recommendations for chronic pain management, and pharmacological treatments are often inadequate. 

To address this gap, researchers conducted a systematic review to determine the efficacy of non-pharmacological and non-invasive interventions for pain relief in COPD and identify the behavior change techniques (BCTs) associated with effective pain management. They followed established guidelines and searched 14 electronic databases for controlled trials that evaluated pain outcomes or included pain subscales. The review was conducted following Preferred Reporting Items for Systematic Review (PRISMA), Systematic review without Meta-analysis (SWIM) standards, and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guidelines.

The systematic review identified a total of 29 studies that involved 3,228 participants. Out of the seven interventions that reported a minimally important clinical difference in pain outcomes, only two of these interventions reached statistical significance (P < 0.05). One study reported statistically significant outcomes but was not clinically significant (P = 0.0273). In addition, the review noted issues with intervention reporting that prevented the identification of active intervention ingredients, also known as behavior change techniques (BCTs).

The pain seemed to be a significant problem for many people with COPD. The effectiveness of currently accessible non-pharmacological therapies, however, cannot be determined with absolute certainty due to intervention heterogeneity and methodological quality problems. It was necessary to improve reporting to identify the active intervention components linked to efficient pain management. 

Reference: resmedjournal.com/article/S0954-6111(23)00079-3/fulltext