A current review of distraction-based interventions for chronic pain management

Introduction: Chronic pain is a global public health problem, which impairs the physical, mental and social well-being of afflicted individuals. Distraction-based interventions have been posited as one approach to divert attention away from noxious stimulation and thereby modulate the severity of pain. The current review aimed to identify studies that explicitly used distraction-based interventions for patients with chronic pain. Methods: The review methodology was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Databases including PubMED, EMBASE, PsychINFO, and CINAHL were searched using combinations of keywords. Studies from the last decade (2005-2015) were included if they (a) were published in English, (b) used experimental or quasi-experimental designs, (c) explicitly used distraction as an intervention for pain, and, (d) evaluated measures of pain pre-post intervention. Results: A total of 12 studies that examined distraction-based interventions for chronic pain were included in this review. Most interventions were evaluated in adults with chronic pain conditions, such as fibromyalgia, and involved a combination of activities including internal and external distraction techniques. There was wide variation in the implementation of interventions, particularly in the use of practice sessions, dose frequency and duration. Conclusion: Distraction was not sufficiently elaborated upon in the theoretical frameworks. Directions for future research are discussed including the use of standardized pain, symptom, and outcome measures and tailored intervention approaches based on the individual's level of distractibility. Strategies to target the individual's distraction threshold could lead to greater precision in delivery of effective interventions to reduce pain. (C) 2016 Elsevier GmbH. All rights reserved.