The Management of Chronic Pain in Older Adults: Randomized Controlled Trial of a Physical and Cognitive-behavioral Intervention Program

BACKGROUND: Pain is very common among older adults. Studies elsewhere have shown that physical interventions and psychological methods based on the cognitive-behavioral approach are both effective in alleviating pain. Yet, evidence-based pain management program for older people in Hong Kong is lacking. especially one that incorporates psychological methods. In view of the aging of the population and the prevalence of chronic pain in older adults, there is a need to put together a comprehensive pain management program that combines cognitive-behavioral methods with physical exercise. Such a program should be readily implementable by allied health professionals in general in view of the manpower situation in Hong Kong. OBJECTIVE: To evaluate the benefits of a physical and cognitive-behavioral intervention program in alleviating pain intensity, pain-related functional difficulties, and depressive symptoms among older adults with chronic musculoskeletal pain in Hong Kong. DESIGN: Cluster-Randomized Controlled Trial. METHODS: A sample of 100 participants aged  60 years will be recruited from social service centers for older people and public medical services. Eligible and consented patients will be first assessed with a face-to-face interview on a battery of questionnaires assessing pain intensity and interference, depressive symptoms, functional health, health-related quality of life, healthcare utilization patterns, and clinical and socio-demographic characteristics. Those meeting the inclusion criteria will be randomized into treatment and active (treatment as usual or TAU) control groups. For the TAU, participants will receive a 10-week chronic pain education program constructed around the contents of a pain information booklet that is disseminated by the Hospital Authority to patients in medical settings [1]. For the treatment group, participants will receive a multimodal intervention of the same duration that is composed of easy-to-implement physical exercises and cognitive-behavioral techniques to manage pain. After the intervention, the same questionnaires would be used to assess effects of the treatment on the primary outcome (pain intensity) as well as the secondary outcome variables (i.e., pain interference, coping, pain cognitions, depressive symptoms, and health-related quality of life) at post-intervention and at 3 and 6 months’ follow-up.

Funding Source: HK Private Fund - Charities/Foundations^^