Interventions to Enhance Work Participation in People with Chronic Pain: A Systematic Review and Meta-Analysis including Analysis of Complex Psychological Intervention Components

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

doi:10.1111/bjhp.70077

Interventions to Enhance Work Participation in People with Chronic Pain: A Systematic Review and Meta-Analysis including Analysis of Complex Psychological Intervention Components

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

Glasgow Caledonian University
University of Glasgow
University of the West of Scotland
University of Aberdeen
University of Strathclyde
Patient Partner with Lived Experience of Chronic Pain Aberdeen UK
Bath Spa University
University of Northumbria at Newcastle
University of Manchester
Monash University

Research output: Contribution to journal › Article › peer-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; I2 = 0%) but not work ability/capacity (SMD −.02, 95% CI: −.12–.08, I2 = 0%) or return to work (RR .98, 95% CI: .91–1.05, I2 = 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.

Original language	English
Article number	e70077
Journal	British Journal of Health Psychology
Volume	31
Issue number	2
Early online date	8 May 2026
DOIs	https://doi.org/10.1111/bjhp.70077
Publication status	Published - 31 May 2026

Data Availability Statement

This is a systematic review and no primary data were collected. The review was registered with PROSPERO (ID: CRD42022375328).

Acknowledgements

The authors would like to thank all the members of the Project Advisory Group for helping to guide the conduct of the review, including Laura Adelman, Jayne Andersen, Bob Doris, Cathy Evans, Charlene Fletcher, Shirley Morrison-Glancy, Laura Macleod, Laura Manley, Louise Murray, Jo McDairmid, and Brian Rich. We would also like to thank Michele Boon for providing advice about the methods within the review.

Funding

This project was funded by the NIHR (NIHR 203430/Policy Research Programme). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. ED wishes to acknowledge funding from the Medical Research Council, United Kingdom (MC_UU_00022/2) and the Chief Scientist Office, Scottish Government Health and Social Care Directorate (SPHSU17).

Keywords

pain
work
chronic pain
behaviour change techniques
meta-analysis
theoretical domains
work outcomes
systematic review
intervention functions

ASJC Scopus subject areas

Applied Psychology

Access to Document

10.1111/bjhp.70077Licence: CC BY

https://bpspsychub.onlinelibrary.wiley.com/doi/10.1111/bjhp.70077Licence: CC BY

Cite this

McParland, J., Booth, L., Dibben, G., Abaraogu, U., Wainwright, E., Demou, E., Williams, L., Flowers, P., Kidd, L., Daniels, J., Patwa, H., Wegrzynek, P., Audsley, S., O'Kane, R., Parchment, A., Ranaldi, H., & Walker‐Bone, K. (2026). Interventions to Enhance Work Participation in People with Chronic Pain: A Systematic Review and Meta-Analysis including Analysis of Complex Psychological Intervention Components. British Journal of Health Psychology, 31(2), Article e70077. https://doi.org/10.1111/bjhp.70077

Interventions to Enhance Work Participation in People with Chronic Pain: A Systematic Review and Meta-Analysis including Analysis of Complex Psychological Intervention Components. / McParland, Joanna; Booth, Lorna; Dibben, Grace et al.
In: British Journal of Health Psychology, Vol. 31, No. 2, e70077, 31.05.2026.

Research output: Contribution to journal › Article › peer-review

McParland, J, Booth, L, Dibben, G, Abaraogu, U, Wainwright, E, Demou, E, Williams, L, Flowers, P, Kidd, L, Daniels, J, Patwa, H, Wegrzynek, P, Audsley, S, O'Kane, R, Parchment, A, Ranaldi, H & Walker‐Bone, K 2026, 'Interventions to Enhance Work Participation in People with Chronic Pain: A Systematic Review and Meta-Analysis including Analysis of Complex Psychological Intervention Components', British Journal of Health Psychology, vol. 31, no. 2, e70077. https://doi.org/10.1111/bjhp.70077

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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; I2 = 0\%) but not work ability/capacity (SMD −.02, 95\% CI: −.12–.08, I2 = 0\%) or return to work (RR .98, 95\% CI: .91–1.05, I2 = 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.",

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AU - Wainwright, Elaine

AU - Demou, Evangelia

AU - Williams, Lynn

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AU - Kidd, Lisa

AU - Daniels, Jo

AU - Patwa, Hussein

AU - Wegrzynek, Paulina

AU - Audsley, Sarah

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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

Abstract

Data Availability Statement

Acknowledgements

Funding

Keywords

ASJC Scopus subject areas

Access to Document

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