Consumer perspectives of the group itself in group-delivered programs for people with chronic pain: A systematic review and meta-synthesis

Group-delivered programs for chronic pain are evidence-based and frequently used. The contribution of group factors to outcomes is unclear and there are no integrated findings on consumer perceptions of the group itself in programs for people with chronic pain. The aim of this systematic review was to search and synthesise qualitative data specifically related to the group itself in studies investigating group-delivered programs for people with chronic pain (PROSPERO, CRD42023382447). MEDLINE, EMBASE, EmCare, PsycINFO, Scopus, and CINAHL databases were searched, and qualitative studies that explored the experiences of consumers who had attended any style of group-delivered program for people with chronic pain were included. Methodological quality was assessed using the Critical Appraisal Skills Programme checklist and meta-synthesis was guided by a thematic synthesis approach. Ninety-three studies were included, with 1806 participants. Programs were predominantly multi-component, with diverse interventions and facilitators. Three analytical themes were generated: (1) Peer interaction: a program component in and of itself; (2) Comparison: frequently used and mostly helpful; and (3) Beyond the program: when the group itself contributes to change. Findings highlighted that most consumers valued the group itself, finding interaction, and comparing themselves with peers useful. Future research related to group factors in programs for people with chronic pain should include consumer participation and co-design. Perspective: This review demonstrates that many consumers valued peer interaction and used comparison-based cognitive processing within group-delivered programs for chronic pain. Dialogue-based interactions with similar others promoted cognitive, affect, and behaviour changes. Group factors may have been underestimated and outcomes could be influenced if peer interactions within programs were optimised.