Enhancing Motivation for Change in the Management of Chronic Painful Conditions: a Review of Recent Literature
Abstract
Purpose of review The purpose of this review is to evaluate and summarize recent empirical research investigating motivational factors for management of chronic pain and headache disorders.Recent findings Research on motivation for non-pharmacological treatment of chronic pain and headache disorders has identified factors that influence initiation of and adherence to treatment. To address common factors that inhibit initiation of treatment (i.e., cost, time commitment), several electronic treatments have been developed. Self-efficacy is the most commonly studied psychosocial influence on treatment adherence, with evidence that it is positively correlated with adherence. Other studies have sought to improve adherence to treatment using motivational interviewing interventions. There is currently limited research on how to enhance motivation for initial adherence to non-pharmacological treatment for chronic pain and headache disorders. Instead of enhancing motivation, researchers have looked to reduce barriers to treatment with electronic health treatments; however, many of these studies have focused on intervention feasibility, rather than efficacy or effectiveness. Numerous studies have identified a relationship between self-efficacy and treatment adherence. Although motivational interviewing interventions have been shown to improve adherence to treatment, there is little evidence that they improve treatment outcomes. Recommendations for further investigation include improving interventions to enhance accessibility and adherence to treatment with the goal of improving outcomes, as well as identifying ways to improve treatment initiation and adherence in patients who are currently engaged in long-term opioid therapy.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Barriers to in-person psychological treatment for chronic pain include availability, financial costs, distance to treatment site, transportation issues, and personal preferences.
“with barriers to treatment including availability, financial costs, distance to treatment site, transportation issues, and personal preferences [15,16].”
From Short-Term Findings From Testing EPIO, a Digital Self-Management Program for People Living With Chronic Pain: Randomized Controlled Trial (2023) · cites this paper as [16]
Cites
CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016
Dowell, D., Haegerich, T. M., & Chou, R. (2016) · JAMA · doi:10.1001/jama.2016.1464 · Cited by 5,161 · see citing works
Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States, 2016
Dahlhamer, J., Lucas, J., Zelaya, Nahin, R., Mackey, S., DeBar, L., Kerns, R., Von Korff, M., Porter, L., & Helmick, C. (2018) · MMWR. Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6736a2 · Cited by 2,598 · see citing works
Self-citationRebooting psychotherapy research and practice to reduce the burden of mental illness
Kazdin, A. E., & Blase, S. L. (2011) · Perspectives on Psychological Science · doi:10.1177/1745691610393527 · Cited by 1,254 · see citing works
Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis
Vickers, A. J., Vertosick, E., Lewith, G. T., MacPherson, H., Foster, N. E., Sherman, K. J., Irnich, D., Witt, C. M., & Linde, K. (2017) · Journal of Pain · doi:10.1016/j.jpain.2017.11.005 · Cited by 908 · see citing works
Meta-analysis of psychological interventions for chronic low back pain
Hoffman, B. M., Papas, R. K., Chatkoff, D. K., & Kerns, R. D. (2007) · Health Psychology · doi:10.1037/0278-6133.26.1.1 · Cited by 844 · see citing works
Self-citationCherkin, D. C., Sherman, K. J., Balderson, B. H., Cook, A. J., Anderson, M. L., Hawkes, R. J., Hansen, K. E., & Turner, J. A. (2016) · JAMA · doi:10.1001/jama.2016.2323 · Cited by 729 · see citing works
Burch, R. C., Rizzoli, P. B., & Loder, E. (2018) · Headache The Journal of Head and Face Pain · doi:10.1111/head.13281 · Cited by 499 · see citing works
Alperstein, D., & Sharpe, L. (2016) · The Journal of Pain · doi:10.1016/j.jpain.2015.10.021 · Cited by 342 · see citing works
Hurley, M., Dickson, K., Hallett, R., Grant, R., Hauari, H., Walsh, N. E., Stansfield, C., & Oliver, S. R. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010842.pub2 · Cited by 322 · see citing works
Turk, D. C., & Rudy, T. E. (1991) · Pain · doi:10.1016/0304-3959(91)90142-k · Cited by 311 · see citing works
Barriers and facilitators to use of non-pharmacological treatments in chronic pain
Becker, W. C., Dorflinger, L., Edmond, S. N., Islam, L., Heapy, A. A., & Fraenkel, L. (2017) · BMC Family Practice · doi:10.1186/s12875-017-0608-2 · Cited by 281 · see citing works
Self-citationPfingsten (1997) · doi:10.1016/s0304-3959(97)00038-9 · Cited by 272 · see citing works
Toward the development of a motivational model of pain self-management
Jensen, M. P., Nielson, W. R., & Kerns, R. D. (2003) · Journal of Pain · doi:10.1016/s1526-5900(03)00779-x · Cited by 254 · see citing works
Self-citationPalermo, T. M., Law, E. F., Fales, J., Bromberg, M. H., Jessen-Fiddick, T., & Tai, G. (2016) · Pain · doi:10.1097/j.pain.0000000000000348 · Cited by 244 · see citing works
Opioid therapy for chronic pain in the United States: Promises and perils
Sullivan, M. D., & Howe, C. Q. (2013) · Pain · doi:10.1016/j.pain.2013.09.009 · Cited by 231 · see citing works
Kerns, R. D., & Rosenberg, R. (2000) · Pain · doi:10.1016/s0304-3959(99)00184-0 · Cited by 168 · see citing works
Self-citationMartínez-Calderón, J., Meeus, M., Struyf, F., Morales‐Asencio, J. M., Gijón-Noguerón, G., & Luque-Suárez, A. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-020703 · Cited by 163 · see citing works
Schäfer, A. G. M., Zalpour, C., von Piekartz, H., Hall, T. M., & Paelke, V. (2018) · Journal of Medical Internet Research · doi:10.2196/jmir.9465 · Cited by 117 · see citing works
Heapy, A. A., Higgins, D. M., Goulet, J. L., LaChappelle, K. M., Driscoll, M. A., Czlapinski, R. A., Buta, E., Piette, J. D., Krein, S. L., & Kerns, R. D. (2017) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2017.0223 · Cited by 101 · see citing works
Self-citationProviders’ roles in enhancing patients’ adherence to pain self management
Dorflinger, L., Kerns, R. D., & Auerbach, S. M. (2013) · Translational Behavioral Medicine · doi:10.1007/s13142-012-0158-z · Cited by 97 · see citing works
Self-citationMatthias, M. S., Krebs, E. E., Bergman, A. A., Coffing, J., & Bair, M. J. (2013) · European Journal of Pain · doi:10.1002/j.1532-2149.2013.00426.x · Cited by 91 · see citing works
Goals of Chronic Pain Management: Do Patients and Primary Care Physicians Agree and Does it Matter?
Henry, S. G., Bell, R. A., Fenton, J. J., & Kravitz, R. L. (2017) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000000488 · Cited by 87 · see citing works
Thompson, E. L., Broadbent, J., Bertino, M. D., & Staiger, P. K. (2016) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000000235 · Cited by 84 · see citing works
A critical review of the pain readiness to change model
Kerns, R. D., & Habib, S. (2004) · The Journal of Pain · doi:10.1016/j.jpain.2004.06.005 · Cited by 84 · see citing works
Self-citationKerns, R. D., Burns, J. W., Shulman, M., Jensen, M. P., Nielson, W. R., Czlapinski, R. A., Dallas, M. I., Chatkoff, D. K., Sellinger, J. J., Heapy, A. A., et al. (2013) · Health Psychology · doi:10.1037/a0034406 · Cited by 81 · see citing works
Self-citationSpecific and general therapeutic mechanisms in cognitive behavioral treatment of chronic pain
Burns, J. W., Nielson, W. R., Jensen, M. P., Heapy, A., Czlapinski, R., & Kerns, R. D. (2015) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0037208 · Cited by 77 · see citing works
Self-citationMatsuzawa, Y. K., Lee, Y. S. C., Fraser, F., Langenbahn, D. M., Shallcross, A. J., Powers, S. W., Lipton, R. B., Simon, N. M., & Minen, M. T. (2018) · Headache The Journal of Head and Face Pain · doi:10.1111/head.13429 · Cited by 67 · see citing works
Brooks, J., Iwanaga, K., Chiu, C.-Y., Cotton, B. P., Deiches, J., Morrison, B., Moser, E., & Chan, F. (2017) · Psychology Health & Medicine · doi:10.1080/13548506.2017.1282161 · Cited by 60 · see citing works
Cognitive-Motivational Influences on Health Behavior Change in Adults with Chronic Pain
Anderson, R. J., Hurley, R. W., Staud, R. M., & Robinson, M. E. (2015) · Pain Medicine · doi:10.1111/pme.12929 · Cited by 58 · see citing works
Chang, Y., Compton, P. A., Almeter, P., & Fox, C. H. (2014) · Perspectives In Psychiatric Care · doi:10.1111/ppc.12082 · Cited by 58 · see citing works
Electronic behavioral interventions for headache: a systematic review
Minen, M. T., Torous, J., Raynowska, J., Piazza, A., Grudzen, C., Powers, S., Lipton, R., & Sevick, M. A. (2016) · The Journal of Headache and Pain · doi:10.1186/s10194-016-0608-y · Cited by 58 · see citing works
Simmonds, M. J., Finley, E. P., Arismendez, S. V., Pugh, M. J., & Turner, B. J. (2014) · Pain Medicine · doi:10.1111/pme.12626 · Cited by 55 · see citing works
Pain Self-efficacy Mediates the Relationship Between Depressive Symptoms and Pain Severity
Skidmore, J. R., Koenig, A. L., Dyson, S. J., Kupper, A. E., Garner, M. J., & Keller, C. J. (2014) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000000094 · Cited by 47 · see citing works
Seng, E. K., Prieto, P., Boucher, G., & Vives‐Mestres, M. (2018) · Headache The Journal of Head and Face Pain · doi:10.1111/head.13422 · Cited by 42 · see citing works
Management of chronic pain through pain management programmes
Wilson, I. R. (2017) · British Medical Bulletin · doi:10.1093/bmb/ldx032 · Cited by 36 · see citing works
Stevens, J., Hayes, J., & Pakalnis, A. (2014) · Cephalalgia · doi:10.1177/0333102413515336 · Cited by 34 · see citing works
Day, M. A., Halpin, J., & Thorn, B. E. (2016) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000000277 · Cited by 29 · see citing works
Lukewich, J., Mann, E. G., VanDenKerkhof, E. G., & Tranmer, J. E. (2015) · Journal of Advanced Nursing · doi:10.1111/jan.12717 · Cited by 29 · see citing works
Finlay, K. A., & Elander, J. (2016) · British Journal of Health Psychology · doi:10.1111/bjhp.12194 · Cited by 24 · see citing works
Alberts, N. M., Law, E. F., Chen, A., Ritterband, L. M., & Palermo, T. M. (2018) · Internet Interventions · doi:10.1016/j.invent.2018.07.005 · Cited by 14 · see citing works
Predictors of Participation in a Nonpharmacological Intervention for Chronic Back Pain
Higgins, D. M., LaChappelle, K. M., Serowik, K. L., Driscoll, M., Lee, A., & Heapy, A. A. (2018) · Pain Medicine · doi:10.1093/pm/pny077 · Cited by 13 · see citing works
Factors involved in patients’ perceptions of self-improvement after chronic pain treatment
Shaikh, M., & Hapidou, E. G. (2018) · Canadian Journal of Pain · doi:10.1080/24740527.2018.1476821 · Cited by 12 · see citing works
Level of readiness of chronic pain patients to practise active self‐care
Scala, E., Décosterd, I., Faouzi, M., Burnand, B., & Rodondi, P. (2018) · European Journal of Pain · doi:10.1002/ejp.1276 · Cited by 10 · see citing works
Onorati, F., Gherli, R., Mariscalco, G., Girdauskas, E., Quintana, E., Santini, F., Feo, M. D., Sponga, S., Tozzi, P., Bashir, M., et al. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-018036 · Cited by 5 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Guideline No. 445: Management of Chronic Pelvic Pain
Allaire, C., Yong, P. J., Bajzak, K., Jarrell, J., Lemos, N., Miller, C., Morin, M., Nasr-Esfahani, M., Singh, S. S., & Chen, I. (2024) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/j.jogc.2023.102283 · Cited by 53 · see citing works
Engaging with EPIO, a digital pain self-management program: a qualitative study
Bostrøm, K., Varsi, C., Eide, H., Børøsund, E., Kristjansdottir, Ó. B., Schreurs, K. M. G., Waxenberg, L. B., Weiss, K. E., Morrison, E. J., Nordang, E. F., et al. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-07963-x · Cited by 18 · see citing works
“For example, self-efficacy, or one’s belief that one can utilize the self-management techniques, may play an important role in this type of engagement [43, 53] and as several participants in the current study described an improved sense of control and self-confidence from the use of EPIO, this may indicate a potential…”
BackgroundBostrøm, K., Børøsund, E., Eide, H., Varsi, C., Kristjansdottir, Ó. B., Schreurs, K. M. G., Waxenberg, L. B., Weiss, K. E., Morrison, E. J., Stavenes Støle, H., et al. (2023) · Journal of Medical Internet Research · doi:10.2196/47284 · Cited by 12 · see citing works
“Regrettably, such evidence-based in-person psychological treatments are not always offered or accessible [7,14], with barriers to treatment including availability, financial costs, distance to treatment site, transportation issues, and personal preferences [15,16].”
- Authors
- Ankawi, B., Kerns, R. D., & Edmond, S. N.
- Affiliations
- VA Connecticut Healthcare System (US)
- Yale University (US)
- Corresponding author
- Ankawi, Brett
- Venue
- Current Pain and Headache Reports
- Published
- 2019-08-06
- Volume
- 23
- Issue
- 10
- Pages
- 75-75
- ISSN
- 1531-3433 (ISSN-L)
- 1534-3081
- OpenAlex
- W2966248140
- Cited by
- 26
- References
- 44
- Citations by year
- 2026: 5 · 2024: 4 · 2023: 3 · 2022: 4 · 2021: 6 · 2020: 3 · 2018: 1
- FWCI
- 0.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Pain and Headache Reports (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Psychiatry and Mental health › Migraine and Headache Studies
- Keywords
- chronic pain, headache disorders, medication adherence, treatment initiation, motivation, self-efficacy, motivational interviewing, digital health interventions, non-pharmacological treatment, barriers to treatment, opioid therapy
- MeSH terms
- Analgesics, Opioid, Humans, Time, Treatment Outcome, Chronic Pain, Motivational Interviewing
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
