Self-management intervention for chronic pain in older adults

a randomised controlled trial

Michael K. Nicholas*, Ali Asghari, Fiona M. Blyth, Bradley M. Wood, Robin Murray, Rebecca McCabe, Alan Brnabic, Lee Beeston, Mandy Corbett, Catherine Sherrington, Sarah Overton

*Corresponding author for this work

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

This study compared an outpatient pain self-management (PSM) program, using cognitive-behavioural therapy and exercises, with 2 control conditions in 141 chronic pain patients aged > 65 years. Results immediately posttreatment indicated that relative to the Exercise-Attention Control (EAC) group, the PSM group was significantly improved on measures of pain distress, disability, mood, unhelpful pain beliefs, and functional reach. The mean effect size for these gains was 0.52 (range: 0.44-0.68). By 1-month follow-up, relative to the EAC group, the PSM group remained better on most measures. At the 1-month follow-up, relative to a Waiting List (usual care) (WL) group, the PSM group was significantly improved on measures of pain distress, disability, and unhelpful pain beliefs. The mean effect size for these variables was 0.69 (range: 0.56-0.83). Relative to the WL group, the EAC group made no significant gains on any of the measured variables. At 1-month follow-up, the mean proportion of reliably improved cases (across outcome variables) was 41% (range: 16-60%) for the PSM group, twice that of those who met this criterion in the 2 control conditions (and this difference was statistically significant). Similarly, significantly more (44%) of the PSM group (vs 22% and 20% for the control groups) achieved a clinically significant improvement on pain disability. In the short term at least, cognitive-behavioural therapy-based PSM was more effective than exercises and usual care. (C) 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Original languageEnglish
Pages (from-to)824-835
Number of pages12
JournalPain
Volume154
Issue number6
DOIs
Publication statusPublished - Jun 2013
Externally publishedYes

Keywords

  • Chronic pain
  • Older adults
  • CBT-based pain self-management
  • Randomised trial
  • LOW-BACK-PAIN
  • ANXIETY STRESS SCALES
  • COGNITIVE-BEHAVIORAL TREATMENT
  • CHRONIC HEART-FAILURE
  • CLINICAL-SIGNIFICANCE
  • ELDERLY-PATIENTS
  • FEAR-AVOIDANCE
  • DEPRESSION
  • EFFICACY
  • EXERCISE

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