JMIR Publications

ABSTRACT

Background:

Chronic non-cancer pain (CNCP) is one of the most common health conditions among older adults, affecting their physical, psychological, and social functioning. A bio-psycho-social multimodal approach to CNCP management is currently extensively suggested by international clinical practice guidelines. Recently, the growing development and application of e-Health within pain management has yielded encouraging results in terms of effectiveness and feasibility; however, its use among the older population remains understudied.

Objective:

The overall aim of this scoping review was to systematically map the existing literature about e-Health multimodal (i.e., both physical and psychosocial components) interventions targeting older adults with CNCP.

Methods:

This review adhered to the Joanna Briggs Institute methodology, a protocol was a-priori registered as a preprint in medRxiv.org, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) reporting guideline was utilized for the reporting. Four electronic databases (i.e., PubMed, Cochrane CENTRAL, Web of Science, PsycINFO) were systematically searched for relevant articles. Studies were included when reporting on multimodal interventions delivered through any e-Health modality to individuals aged 65 and over with any type of CNCP condition. Two reviewers were involved in the study selection, first, by screening title/abstract and second, by screening full-text articles. The quality of the included studies was evaluated against the 16-item Quality Assessment Tool. The results of the studies were summarized narratively.

Results:

A total of 9 studies were included. They were mainly randomized controlled trials, recently published, and were rated as medium-high quality. The majority of the studies evaluated self-management interventions, most of which specifically designed for older adults, with an average age of the targeted samples between 65 and 75 years and different CNCP conditions considered (e.g., osteoarthritis, chronic low back pain, etc.). Most of the included studies involved the use of multiple e-Health modalities simultaneously, with a higher use of web-based programs and video-consulting and only one virtual reality-based intervention. The proposed interventions showed signals of effectiveness in the targeted bio-psycho-social outcomes, and the participants' engagement and satisfaction were generally positive. However, several research gaps were identified and discussed.

Conclusions:

Overall, recently there has been a growing interest in the potential that e-Health multimodal interventions offer in terms of improving pain, physical, and psychosocial outcomes in older adults with CNCP. However, the existing literature on this topic still seems scarce and highly heterogeneous, precluding robust conclusions; several gaps emerged in terms of the older population considered and the lack of pathological comorbidities’ evaluation.