Psychosocial interventions for pain management in older adults with dementia: A systematic review of randomized controlled trials

Aim To assess the effectiveness of psychosocial interventions on pain in older adults living with dementia. Design A systematic review with meta-analysis of randomized controlled trials. Data sources Scopus, ProQuest, EBSCO (CINAHL and MEDLINE), PubMed, OVID (PsycINFO), Web of Science, and Cochrane Library were searched from their inception up to 2 May 2018. Review Methods Risk of bias assessment and meta-analysis were conducted according to the Cochrane methods using RevMan 5.3 and findings were generated using the GRADE profiler software. Results Eight studies met the inclusion criteria, but the quality of the current evidence was low to moderate. Results showed that psychosocial interventions significantly reduced the observational pain score and pain medication. Subgroup analyses indicated that sensory stimulation and individual interventions showed a reduction in observational pain in people with dementia. Conclusion Findings suggest that psychosocial interventions may be potentially effective alternatives for pain management in people with dementia. However, caution is needed in interpreting these results due to limited studies, risk of bias and heterogeneity across studies. Furthermore, well-designed research is needed on psychosocial interventions to strengthen quality of pain management in people with dementia. Impact This review synthesized current evidence using psychosocial interventions to manage pain in people with dementia. Findings suggest that psychosocial interventions may lead to a potential reduction in pain and pain medication in people with dementia. Healthcare providers may wish to integrate psychosocial interventions as part of the multimodal approach to the management of pain in people living with dementia.