Effectiveness of Psychological Interventions to Improve Quality of Life in People With Long-Term Conditions: Rapid Systematic Review of RCTs - 2018

[Sly Saint]

Effectiveness of Psychological Interventions to Improve Quality of Life in People With Long-Term Conditions: Rapid Systematic Review of Randomised Controlled Trials

Niall Anderson 1 2 , Gozde Ozakinci 3

Abstract
Background: Long-term conditions may negatively impact multiple aspects of quality of life including physical functioning and mental wellbeing. The rapid systematic review aimed to examine the effectiveness of psychological interventions to improve quality of life in people with long-term conditions to inform future healthcare provision and research.

Methods: EBSCOhost and OVID were used to search four databases (PsychInfo, PBSC, Medline and Embase). Relevant papers were systematically extracted by one researcher using the predefined inclusion/exclusion criteria based on titles, abstracts, and full texts. Randomized controlled trial psychological interventions conducted between 2006 and February 2016 to directly target and assess people with long-term conditions in order to improve quality of life were included. Interventions without long-term condition populations, psychological intervention and/or patient-assessed quality of life were excluded.

Results: From 2223 citations identified, 6 satisfied the inclusion/exclusion criteria. All 6 studies significantly improved at least one quality of life outcome immediately post-intervention. Significant quality of life improvements were maintained at 12-months follow-up in one out of two studies for each of the short- (0-3 months), medium- (3-12 months), and long-term (≥ 12 months) study duration categories.

Conclusions: All 6 psychological intervention studies significantly improved at least one quality of life outcome immediately post-intervention, with three out of six studies maintaining effects up to 12-months post-intervention. Future studies should seek to assess the efficacy of tailored psychological interventions using different formats, durations and facilitators to supplement healthcare provision and practice.

https://pubmed.ncbi.nlm.nih.gov/29587884/

eta: posted this study as is basis of article in next post.

 

[Sly Saint]

Psychological interventions for patients with chronic illness

A recent review looked at six studies of differing lengths to determine which psychological interventions improved mental well-being.
...

Conducted in the United Kingdom, the review has divided six different studies into three categories: short-term, medium-term, and long-term psychological interventions. The researchers assessed the results both immediately after and at 12 months follow-up, as well as methodological quality.

Short-term psychological interventions show promise but are subject to strong selection bias

Medium-term psychological interventions demonstrate some effectiveness

Long-term psychological interventions show that nurses can provide effective treatment

Implications for future research
As published in BMC Psychology, the authors show that an important point for future research would be the high selection bias in these samples, with as low a figure as 41% for successful recruitment in one of the studies.

Since current treatment for long-term conditions is medication-based, many patients often seek quick fixes. As the authors could only find six studies which fit the criteria, it is important to employ more studies to look at the effect of psychological interventions on chronic patients.

https://medicalnewsbulletin.com/psychological-interventions-patients-chronic-illness/

 

[Gaspard]

Out of 2223 citations, only 6 studies were used. 1727 were excluded because a full text was not available!? Plenty of authors will send a PDF of their article, when you send a friendly email, especially when you're a fellow academic.

When you manage to assess only 0.27% of the studies in your selected field, it's time to revaluate what you're trying to accomplish.

 

[Snowdrop]

In general all studies of this nature that include long term outcomes are fooling themselves as to what constitutes 'long term' . It may well be seen as long term for these type of studies but it is most definitely not long term with regard to a person's life with chronic illness. Long term effectiveness in real life must be seen as ongoing effectiveness just as you would expect for a drug therapy.

Also, I cannot see in the paper or any others I've read something else important to the people being studied. What precisely are they meaning when they refer to improvement of Quality of Life. It needs to be concrete, specific and applicable to everyday life not just a better score on a questionnaire.

These studies are always designed for the most minimal engagement with participants and to benefit the researcher by reassuring them that their preconceived notions of chronic illness and their preferred treatment are valid.

I fail to understand how people who do this research can continue to believe in what they write / find as being of value to the people for whom it's meant to be useful. Would possibly transient and minimal changes on a questionanire score be enough for them in the circumstances?

After seeing this type of stuff over many years now, IMO there is no benefit in even discussing the quality of reviews or original research of this type. Creating questions that have been developed by people without any experience of illness based on their pulling beliefs out of preconceived biases to start with is meaningless as valuable intelligence into real world concrete changes to quality of life.*

I'm inclined to think that they might actually benefit from some more open-minded thinking (not bringing preformed constructs to bias the research discovery). There is actually some research done as anthropology that might be useful toward teaching psychologists how to let go of their allegiance to their preconceived notions of what they view as "useful / helpful" to the lives of people with chronic illness.

NB: I haven't read all of the text (scanned mostly) to the following link but it's an example of a different approach:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4390365/

*I don't deny the possibility that for some there may be minor and/or transient value but chronically ill people deserve better than this. And they continue for decades with this stuff constantly 'refining' it as if doing that will yield something more substantial. It will only yield better results on paper IMO, not anything real.

Also, I'm not suggesting that anthropological research is what is needed for ME research. Just that it might be helpful to psychology researchers bent on believing everything they find on a questionnaire.