It is well documented that severe pain is more common in older adults than it is younger persons. Of concern, older adults may not have access to traditional face-to-face self-management programs, which are recognized to be valuable in chronic pain management. Access to effective self-management approaches is particularly important for older adults who may have mobility limitations or live in remote areas, or have difficulty accessing health care services. The development of effective pain self-management programs for older adults who cannot access traditional psychological interventions is of significant importance. Internet self-management programs have the potential to address pain undermanagement. As technology advances, the digital divide between the older and younger demographic continues to progress. Given the known difficulties with treatment access, the purpose of this study is to explore the efficacy and acceptability of a remotely-delivered chronic pain self-management program tailored to older adults, the Pain Course, when delivered in online and workbook formats. The program was previously shown to be effective among younger persons but has not been tested with older adults.
The program is delivered through a secure platform administered by the Online Therapy Unit for Service Education and Research at the University of Regina. Using a patient preference randomized control trial (RCT) design, participants (n = 120) will be enrolled in either the online group or workbook group, or to a wait list control group. The content of both programs will be identical and contain 5 core lessons, which participants will be encouraged to work through over an 8-week period. By exploring the efficacy of an online vs. workbook group, the results from this study may serve as a stepping-stone for improved self-management of chronic pain in older adults. A patient preference randomized controlled trial (RCT) was chosen for this study. The goal is to have most participants accept randomization by emphasizing they are equally acceptable, so only those with a very strong preference or no access to Internet aren't randomized. According to the preliminary power analysis, a total of 120 participants will be randomly assigned to be enrolled in the online group or workbook group, or be placed on a twelve-week wait list control, which will serve as a control group to control for the influence of time on symptom change between groups.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
121
An 8-week remotely-delivered pain self-management program tailored to older adults that will be delivered in an online format.
An 8-week remotely-delivered pain self-management program tailored to older adults that will be delivered in a printed (workbook) format.
University of Regina
Regina, Saskatchewan, Canada
Change in the impact of pain in several areas of life
Measured by Pain Disability Index (PDI)
Time frame: baseline, 8 weeks, 3 months
Change in depression
Measured by Geriatric Depression Scale-30 (GDS-30)
Time frame: baseline, 8 weeks, 3 months
Change in anxiety
Measured by Generalized Anxiety Disorder Scale 7-Item (GAD-7)
Time frame: baseline, 8 weeks, 3 months
Change in chronic pain severity
Measured by Brief Pain Inventory (BPI)
Time frame: baseline, 8 weeks, 3 months
Change in beliefs about one's ability to perform every day tasks regardless of chronic pain
Measured by Pain Self-Efficacy Questionnaire (PSEQ)
Time frame: baseline, 8 weeks, 3 months
Change in fear of movement or re-injury
Measured by TAMPA Scale of Kinesiophobia (TSK)
Time frame: baseline, 8 weeks, 3 months
Change in acceptance of chronic pain
Measured by Chronic Pain Acceptance Questionnaire (CPAQ-8)
Time frame: baseline, 8 weeks, 3 months
Change in tendency to amplify the threat value of constant pain
Measured by Pain Catastrophizing Scale (PCS)
Time frame: baseline, 8 weeks, 3 months
Treatment satisfaction
Measured by Treatment Satisfaction Questions (TSQ) used in Pain Course
Time frame: 8 weeks
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