Stefan Elbers

84 Chapter 4 pain intensity and physical activity. We hypothesized that self-management interventions would improve self-efficacy, enabling patients with chronic pain to increase their physical activity, consequently reducing their perceived limitations in physical function, at least in the short-term. Attributable to a shift in attention from disease-related problems to engagement in daily life activities, patients might even perceive less pain after the intervention. Our secondary aim was to describe the intervention content, by means of classification according to the Behaviour Change Technique Taxonomy (v1). This aim builds on recent efforts to acquire more insight into theory and techniques behind self-management interventions (e.g. Keogh et al., 2015). METHOD Protocol and Registration The review protocol has been registered in the Prospero database (CRD42015024417). Information Sources We searched MEDLINE via PubMed, CENTRAL, Embase and Psycinfo databases for eligible studies from inception up to May 2017. The search strategy was designed in collaboration with a medical informatics specialist and contained a combination of thesaurus terms and free text words. The PubMed search string (see Supplement 1) was constructed first and was used as a template for the other databases. The database search was extended in the following ways: first, reference lists of included articles were screened by one of the researchers (SE) and eligible studies underwent the same reviewing process (i.e. backward citation tracking). Second, when a study was included in the analysis, PubMed was used to search for eligible studies that cited this study (i.e. forward citation tracking). Third, to minimize publication bias, we also searched for unpublished studies and grey literature in DART-Europe E-thesis portal, the Open Access Thesis and Dissertations database (OATD), the WHO International Clinical Trials Registry Platform (WHO-ICTRP), and the Networked Digital Library of Theses and Dissertations (NDLTD) with the combined terms ‘chronic pain’ and ‘self-management’ as entry terms. Eligibility Criteria We included randomized controlled trials that met the following eligibility criteria: The study sample had to consist of adult patients with chronic musculoskeletal pain, defined as pain that persists for longer than 3 months and that is perceived in the musculoskeletal