Results of a randomized controlled trial to examine the efficacy of a chronic pain self-management group for older adults [ISRCTN11899548]
Open accessAbstract
Chronic pain is a common, disabling problem in older adults. Pain self-management training is a multimodal therapy that has been found to be effective in young to middle-aged adult samples; however, few studies have examined the effectiveness of this therapy in older adults. In this randomized, controlled trial, we evaluated a pain self-management training group (SMG) intervention as compared with an education-only (BOOK) control condition. Participants, 65 years of age or older who experienced persistent, noncancer pain that limited their activities, were recruited from 43 retirement communities in the Pacific Northwest of the United States. The primary outcome was physical disability, as measured by the Roland-Morris Disability Questionnaire. Secondary outcomes were depression (Geriatric Depression Scale), pain intensity (Brief Pain Inventory), and pain-related interference with activities (Brief Pain Inventory). Randomization occurred by facility to minimize cross-contamination between groups. Two-hundred and fifty-six individuals, mean age=81.8 (SD: 6.5), enrolled and 218 completed the study. No significant differences in outcomes were found between groups at post-intervention, 6-month follow-up, or 12-month follow-up. The SMG group showed a significantly greater increase over time, relative to the BOOK group, in two process measures, as measured by the Chronic Pain Coping Inventory: use of relaxation and use of exercise/stretching. In both cases, the increase was greatest from baseline to the post-intervention assessment. Study findings indicate that additional research is needed to determine the most effective content and delivery methods for self-management therapies targeted at older adults with chronic pain.
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For Ersek 2008, allocation concealment was at low risk of bias.
“By independent statistician”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Ersek 2008
For Ersek 2008, blinding of outcome assessment was at unclear risk of bias.
“Not reported”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Ersek 2008
For Ersek 2008, incomplete outcome data was at high risk of bias.
“Completer analysis conducted; attrition > 10%”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Ersek 2008
For Ersek 2008, random sequence generation was at low risk of bias.
“Randomisation by (retirement) facility, by statistician using random number generator”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Ersek 2008
For Ersek 2008, treatment expectations was at unclear risk of bias.
“Not assessed”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Ersek 2008
The Discussion reports participants’ pre-randomization preference for receiving the book, but does not assess treatment expectations or rate their risk of bias. Searches for treatment expectations, expectancy, and bias found no passage supporting the stated rating. (LLM, conf=0.70)
Experimental — accuracy not yet measured
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“One large study [33] found no benefit, relative to a control condition, for CBT-based self-management conducted by trained, psychologist-supervised nurses in retirement communities.”
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The Relationship Between Pain Beliefs and Coping with Pain of Algology Patients'.
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“…of these programs targeted older adults living in retirement communities or at home, but not necessarily in rural settings (Berman et al., 2009; Ersek et al., 2008; Ferrell et al., 1993), and the majority of interventions included adult pain sufferers of all ages (Damush et al., 2003; Lorig et…”
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“components,[78] whereas another study conducted in a similar population did show a 548”
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Evaluation of a Peer Led Chronic Pain Self-Management Program in a Rural Population
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“For patients with chronic pain, intervention programs with self-efficacy enhancing strategies also showed improvements in the intervention groups [28–31].”
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Postoperative Pain Self‐Management Behavior in Patients Who Underwent Total Knee or Hip Arthroplasty
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Using Illness Perceptions to Cluster Chronic Pain Patients
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“Managing pain in the community may require integrating self‐management with treatment from multiple points of the health care team.(14) Such an approach has been shown to be effective in depressed older adults with specific medical conditions such as arthritic pain.”
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“…neck pain [25, 32, 33, 37–39, 46–48, 54], osteoarthritis-or arthritis-related pain [26, 27, 29, 40, 41, 50, 52], musculoskeletal pain [42, 51, 55], unspecified chronic pain or from more than one site in bones, muscles, or joints [28, 30, 31, 34–36, 45, 49, 53], and undiagnosed knee pain [43, 44].”
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“Out of these, two studies found no or small effect (Ersek et al., 2008; Ersek, Turner, McCurry, Gibbons, & Kraybill, 2003), and two studies found some effect on pain, distress, and disability, which were maintained one year after (Nicholas et al., 2013, 2017).”
BackgroundOlder people's use of non-pharmacological interventions for chronic, non-cancer pain and comfort.
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Interdisziplinäre multimodale Schmerztherapie im Alter
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Pain Assessment and Management in Older Adults
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Prognostic Factors of Perceived Disability and Perceived Recovery After Whiplash
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Pain Assessment and Interventions in Later Life
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“Similarly, favorable directional trends were observed across all pain instruments used, including the NRS/VAS, BPI, CPGQ, WOMAC, and PEG.”
InfluentialTrần, T. N. T., & Lê, T. (2023) · Tạp chí Y học Việt Nam · doi:10.51298/vmj.v532i2.7629 · Cited by 1
“Trên thế giới, nghiên cứu của Mary Ersek (2008), so sánh với nhóm chứng, nhóm “Tự quản lý đau” có điểm đau trung bình là 5,4 ± 1,9, sau can thiệp là 4,9 ± 1,9, sau 6 tháng là 4,8 ± 2,2, so sánh với nhóm chứng 5,4 ± 1,8; 5,0 ± 2,1 và 4,6 ± 2,0; với p=0,03, khác biệt giữa 2 nhóm có ý nghĩa thống kê…”
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Link Between Anxiety and Depression and Pain and Sleep Disruption
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Psychosocial Interventions for Chronic Non-Cancer Pain Among Older Adults: A Scoping Review
Low, E. L., Gibson, S. L., Patel, K. B., Hickner, A., Sanni, M., Scher, C. J., & Reid, M. C. (2026) · Journal of Applied Gerontology · doi:10.1177/07334648261462221
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Tse, M.-M. M. Y., He, J., & Kwok, T. (2026) · JMIR Formative Research · doi:10.2196/78823
“…or older; (2) able to read and understand the Mandarin Chinese language; (3) owners of smartphones with internet access; (4) have a previously diagnosed chronic noncancer pain condition lasting more than 3 months; (5) report a score of greater than or equal to 2 on the Visual Analog Scale [22].”
Tse, M. Y. M., He, J., Kwok, T. T. O., & Ho, S. (2026) · JMIR Research Protocols · doi:10.2196/80542
“…criteria: (1) be aged 18 years or older, (2) be able to read and understand Mandarin Chinese, (3) own a smartphone with internet access, (4) have a previously diagnosed chronic noncancer pain condition lasting more than 3 months [40], and (5) report a score of ≥ 2 on the visual analogue scale [41].”
Magill, N., Ismail, K., McCrone, P., & Landau, S. (2015) · Trials · doi:10.1186/1745-6215-16-s2-p7
34 – Management of Pain in Older Adults
Stewart, C., Schofield, P., Gooberman-Hill, R., Mehta, S. S., & Reid, M. C. (2013) · Elsevier eBooks · doi:10.1016/b978-0-323-08340-9.00034-7
Somatoforme Störungen und Schmerzstörungen
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- Authors
- Ersek, M., Turner, J. A., Cain, K. C., & Kemp, C. A.
- Affiliations
- Oregon Health & Science University (US)
- University of Washington (US)
- Corresponding author
- Ersek, Mary
- Venue
- Pain
- Published
- 2008-08-15
- Volume
- 138
- Issue
- 1
- Pages
- 29-40
- ISSN
- 0304-3959 (ISSN-L)
- PMC
- PMC2536565
- OpenAlex
- W2024572151
- Cited by
- 100
- References
- 0
- Citations by year
- 2026: 6 · 2024: 3 · 2023: 5 · 2022: 1 · 2021: 4 · 2020: 3 · 2019: 7 · 2018: 10 · 2017: 5 · 2016: 7 · 2015: 5 · 2014: 10 · 2013: 10 · 2012: 14
- FWCI
- 1.78
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Nursing Research (R01NR007787)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Keywords
- chronic pain, pain self-management, older adults, group intervention, physical disability, depression, pain intensity, pain interference, relaxation, retirement communities, non-cancer pain
- MeSH terms
- Activities of Daily Living, Aged, Aged, 80 and over, Chronic Disease, Depression, Female, Humans, Male, Pain, Pain Measurement, Self Care, Treatment Outcome
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