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Interventions to enhance work participation in people with chronic pain: A systematic review and meta‐analysis including analysis of complex psychological intervention components

Year: 2026
Type: review
Abstract: Purpose Chronic pain impairs work participation. Psychological interventions can support people with chronic pain to work, yet little is known about which components are most effective. A systematic review and meta‐analysis assessed the effectiveness of interventions targeting sick leave, return to work, work ability and work‐related self‐efficacy in chronic pain populations. Intervention content was analysed to identify effective components. Methods A search strategy was developed and applied to six databases from inception until 2nd March 2023, being updated in December 2024: PsychInFO, Medline, Cinahl, Web of Science, Cochrane Library and Embase. Intervention descriptions were coded for intervention functions, theoretical domains and behaviour change techniques. Risk of bias was assessed using the ROB‐2 tool. Results 51 randomized controlled trials were identified. Study quality was poor overall. Meta‐analysis showed that psychological interventions were complex, that is, contained multiple components delivered alongside other interventions, which together were associated with reduced sick leave (SMD −.41, 95% CI: −.64 to −.18) and a small increase in those working at long‐term follow‐up (>12 months) (RR 1.03, 95% CI: 1.01–1.06; I 2 = 0%) but not work ability/capacity (SMD −.02, 95% CI: −.12–.08, I 2 = 0%) or return to work (RR .98, 95% CI: .91–1.05, I 2 = 0%). No intervention components appeared most effective, but five common components were identified: education, skills/training, social support, emotional regulation, and confidence building. Conclusion Complex psychological interventions can positively influence work outcomes for people with chronic pain. Future research should prioritize high‐quality studies and incorporate the five components to enhance work‐focussed support.
DOI: 10.1111/bjhp.70077
Authors: Joanna McParland, Lorna Booth, Grace Dibben, Ukachukwu Abaraogu, Elaine Wainwright, Evangelia Demou, Lynn Williams, Paul Flowers, Lisa Kidd, Jo Daniels, Hussein Patwa, Paulina Wegrzynek, Sarah Audsley, Ronald O'Kane, Amelia Parchment, Hannah Ranaldi, Karen Walker‐Bone
Institutions: Glasgow Caledonian University, University of Glasgow, University of the West of Scotland, University of Aberdeen, University of Strathclyde, University of Bath, Bath Spa University, Northumbria University, University of Manchester, Monash University
Language: English
Subfield: Pharmacology
Field: Medicine
Open Access status: hybrid
Estimated APC paid: $4,240
OpenAlex ID: W7160638664
FWCI: 1.46
Cites: 63
Cited by: 1
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