A Systematic Review of Chronic Pain Management Interventions Among Veterans of Recent Wars and Armed Conflicts
Author: Rital Lakshman1, Emily Tomlinson2, Tracey Bucknall3
Affiliation:
1 School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia. Electronic address: R.lakshman@deakin.edu.au.
2 School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia. Electronic address: https://twitter.com/emjane88.
3 School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia; Centre for Quality and Patient Safety Research - Alfred Health Partnership, Melbourne, Victoria, Australia. Electronic address: https://twitter.com/nursedecisions.
Conference/Journal: Pain Manag Nurs
Date published: 2024 Apr 10
Other:
Pages: S1524-9042(24)00107-3 , Special Notes: doi: 10.1016/j.pmn.2024.03.008. , Word Count: 225
Objectives:
To identify chronic pain management strategies aimed to reduce pain intensity and enhance functional outcomes in veterans of wars and armed conflict.
Design:
Systematic review without meta-analysis.
Data sources:
Key words "chronic pain," "veterans," and "injuries" were used to search for articles in the MEDLINE, CINAHL, APA PsycInfo, and Embase databases. Articles published in English between 2000 and 2023 were included.
Review/analysis methods:
A systematic literature search was conducted in June 2020, updated in April 2023, and managed using Covidence review software. Inclusion criteria focused on combat-injured veterans with chronic pain, excluding nonveterans and civilians treated for acute or chronic pain. Data from included studies were extracted, summarized, and critically appraised using the 2018 Mixed Methods Appraisal Tool. This review is registered with PROSPERO (CRD42020207435).
Results:
Fourteen studies met the inclusion criteria, with 10 of them supporting nonpharmacological approaches for managing chronic pain among veterans of armed conflicts and wars. Interventions included psychological/behavioral therapies, peer support, biofeedback training via telephone-based therapy, manual therapy, yoga, cognitive processing therapy, cognitive-behavioral therapy, and social and community integration to reduce pain intensity and enhance functional outcomes.
Conclusion:
Nonpharmacological treatments for chronic pain have increased in recent years, a shift from earlier reliance on pharmacological treatments. More evidence from randomized controlled trials on the benefits of combined pain interventions could improve pain management of veterans with complex care needs.
PMID: 38604820 DOI: 10.1016/j.pmn.2024.03.008
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