A critical appraisal and grade analysis of RCTs of hypnotherapy for the treatment of chronic pain

POSTER AIMS: A 2014 metaanalysis found that hypnotherapy does reduce chronic pain. The authors asked, "How good is the data supporting the findings of this metaanalysis?" METHODS: A review of literature in Medline, Embase, Psychoinfo Abstract, Proquest, and the Cochrane Institute database was conducted. Only RCTs with hypnotherapy as the intervention and pain reduction as the primary outcome were included,. The analysis involved the Critical Appraisal Methods(CAM) of studies and the GRADE (GR) analysis for the body of research evidence. Each author analyzed the papers with the final appraisal being constructed by discussion amongst the authors until a consensus was reached. RESULT(S): In total, there were 6 RCTs selected. CAM indicated that important measures of function and psychopathology were missing from most papers. Some studies had contaminated controls. The final GR score attained was a 2 out of a maximum of 4 indicating that the quality of the trials upon which the meta-analysis was based, was poor. CONCLUSION(S): Current research suggests that hypnotherapy is efficacious in the treatment of CNCP. However, the quality of this research is suspect. Future research should pay attention to research design. Controls cannot be contaminated. It is vital that functional status and psychopathology are included as outcomes in these RCTs. This will help to shed light on the efficacy of hypnotherapy for the treatment of CNCP.