Evaluating chronic pain interventions in recent refugees and immigrant populations: A systematic review

Abstract

Objectives: Many studies investigating the management of chronic pain often exclude participation of people from refugee and immigrant backgrounds. This review seeks to understand and evaluate the effectiveness of interventions for chronic pain management when applied in the context of refugee and immigrant populations. Methods: A systematic review was undertaken using six databases and the PICO search strategy. Included studies were published in English, comprised of patients over 18 years of age and excluded cancer-related chronic pain. Results: Twenty-one papers met the inclusion criteria: 13 cohort studies and eight randomised control trials. The majority of interventions involved multidisciplinary or psychological interventions, with the remaining studies based on education, exercise therapy or culturally adapted information. Studies integrating multidisciplinary care to manage chronic pain showed more consistent improvements in pain intensity and function than other unimodal interventions. Conclusions: Multidisciplinary interventions reduce pain intensity, improve functional impairment, and alleviate other psychosocial symptoms exhibited chronic pain patients from refugee or immigrant backgrounds. Additional well-designed, large-scale studies are needed to decisively estimate the effectiveness of culturally adapted, multidisciplinary intervention programs over time. Practice Implications: Clinical practice may benefit from adapting interventions to better support the management of chronic pain in refugee and immigrant populations.