• Rebecca Hayward and Siobhan Stynes.
• Department of Pain Medicine, North West Anglia NHS Foundation Trust, Stamford and Rutland Hospital, Stamford, Lincolnshire, UK.
• Musculoskeletal Care. 2021 Sep 1; 19 (3): 278-292.

ObjectiveEvidence on the effectiveness of pain management programmes (PMPs) for chronic pain patients is mixed. Self-efficacy may be associated with outcome of PMPs. The purpose of this systematic review was to assess the role of self-efficacy as a (i) prognostic factor and (ii) moderator of treatment, in chronic musculoskeletal pain (CMP) patients attending a PMP.MethodsA systematic review of the literature and qualitative synthesis was carried out. Six electronic databases were searched (1989-2020). Studies that measured pain self-efficacy as a prognostic factor or treatment moderator in patients with CMP, who participated in a multidisciplinary PMP were included. Study quality was appraised using the Quality in Prognosis Studies (QUIPS) tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.ResultsSix studies investigating self-efficacy as a prognostic factor were included with a total of 1881 participants. No studies were found assessing self-efficacy as a treatment moderator. Self-efficacy was a prognostic factor for physical functioning in two studies. There was weak evidence for self-efficacy as a prognostic factor for disability, health-related quality of life and pain outcomes and no evidence for psychological variables, disease severity and tender point index following PMPs. Quality of evidence was very low using the GRADE system for each outcome measure.ConclusionBaseline self-efficacy may play a role in physical function outcomes in CMP patients attending a PMP. Higher quality evidence is needed to determine the influence of self-efficacy on outcomes in this setting.© 2020 John Wiley & Sons Ltd.

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