Self-management intervention for chronic pain in older adults: A randomised controlled trial
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.
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The estimated SD for changes in RMDQ used for the 6-month changes is 5.4, derived from a previous trial.
“The SD for changes in RMDQ was calculated from data reported in a previous trial52 of 471 participants, with 397 excluding the wait-list control group.52”
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- Authors
- Nicholas, M. K., Asghari, A., Blyth, F. M., Wood, B. M., Murray, R., McCabe, R., Brnabic, A., Beeston, L., Corbett, M., Sherrington, C., & Overton, S.
- Affiliations
- The University of Sydney (AU)
- Shahed University (IR)
- Corresponding author
- Nicholas, Michael K.
- Venue
- Pain
- Published
- 2013-06
- Volume
- 154
- Issue
- 6
- Pages
- 824-835
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W2168681512
- Cited by
- 137
- References
- 69
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 8 · 2023: 8 · 2022: 7 · 2021: 10 · 2020: 12 · 2019: 8 · 2018: 15 · 2017: 15 · 2016: 10 · 2015: 9 · 2014: 14 · 2013: 5 · 2012: 1
- FWCI
- 9.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Australian Health Ministers Advisory Council (AHMAC PDR 2005/08)
- 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, older adults, pain self-management, cognitive behavioral therapy, physical activity, pain beliefs, pain-related disability, pain-related distress, mood, functional reach test, outpatient intervention
- MeSH terms
- Aged, Aged, 80 and over, Exercise Therapy, Female, Humans, Male, Self Care, Cognitive Behavioral Therapy, Treatment Outcome, Chronic Pain, Pain Management
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