The role of the patient-clinician relationship in Chronic Pain Interventions: A systematic review

This systematic review (PROSPERO 2024 CRD42024557180) aims to investigate the status of the current literature regarding the association between patient-clinician relationship and pain-related outcomes in clinical interventions targeting patients with chronic non-cancer pain (CNCP). Five electronic databases, PubMed, PsycINFO, Cochrane, Web of Science, and Scopus, were searched. All studies examining clinical interventions for CNCP that investigated the patient-clinician relationship-identified through MeSH terms such as interpersonal relationship, empathy, and therapeutic alliance- in relation to at least one pain outcome were included. The review adheres to the Joanna Briggs Institute methodology and adopts the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to report data. All eligible studies were evaluated against the 16-item quality assessment tool QATSDD. The first step of the search process identified 3109 studies. After the screening, 37 articles, involving 10,281 patients, were included in the current review. Different clinical interventions were considered (psychological, physical or medical therapy, acupuncture or integrated and miscellaneous interventions). The Clinician-patient relationship was measured through diverse quantitative scales to investigate different dimensions: therapeutic alliance, empathy, trust, clinician-patient interaction, and interpersonal dimensions. Even if the population considered in the review, as well as the measures adopted to evaluate the relationship were highly heterogeneous, findings confirmed that in most cases clinician-patient relationship contributed to ameliorate different pain-related outcomes.