Effectiveness of a Peer-Led Pain Management Program in Relieving Chronic Pain and Enhancing Pain Self-Efficacy Among Older Adults: A Clustered Randomized Controlled Trial

Mimi M Y Tse, Shamay S M Ng, Paul H Lee, Xue Bai, Raymond Lo, Shuk Kwan Tang, Ka Long Chan, Yajie Li, Mimi M Y Tse, Shamay S M Ng, Paul H Lee, Xue Bai, Raymond Lo, Shuk Kwan Tang, Ka Long Chan, Yajie Li

Abstract

Chronic pain is common in nursing home residents, who may have difficulty seeking out pain management strategies. Peer support model show promise as a strategy for managing chronic conditions. This was a clustered randomized controlled trial. A peer-led pain management program was provided for the experimental group. Pain situation, depression, quality of life, non-drug strategies used, and pain knowledge were measured. A total of 262 participants joined the study (146 were allocated as experimental group and 116 as control group). Before our intervention, the mean pain score reported was as high as 6.36 on a 10-point Likert Scale. The high intensity of their pain very much interfered with the daily activities of the participants. Pain interference was high and the participants had poor coping as indicated by the low pain self-efficacy. Depression and a low quality of life score was found. Upon completion of our PAP, there was a significant increase in pain self-efficacy, pain interference as well as quality of life for the participants in the experimental group and not in the control group, and this improvement sustained in 3-month follow up. The present study used a peer support models and proven to be effective in managing pain and pain related situations for nursing home residents with chronic pain. The peer volunteers involved in the pain management program taught relevant pain knowledge and pain management strategies to help our participants. Clinical Trial Registration:https://ichgcp.net/clinical-trials-registry/NCT03823495, NCT03823495.

Keywords: chronic pain; nursing home residents; pain management program; peer-led; randomized controlled trial.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Tse, Ng, Lee, Bai, Lo, Tang, Chan and Li.

Figures

Figure 1
Figure 1
CONSORT 2010 flow diagram.
Figure 2
Figure 2
Estimated marginal means plotted at each measurement time point for GEE models that showed significant Group × Time interactions. Change over time in (A) PSEQ, (B) BPI-Interference, (C) GDS, (D) Chat, and (E) Total non-drug treatment.

References

    1. Abdulla A, Adams N, Bone M, Elliott AM, Gaffin J, Jones D, et al. . Guidance on the management of pain in older people. Age Ageing. (2013) 42:i1–57. 10.1093/ageing/afs200
    1. AGS Panel on Persistent Pain in Older Persons . The management of persistent pain in older persons. J Am Geriatr Soc. (2002) 50(6 Suppl):S205. 10.1046/j.1532-5415.50.6s.1.x
    1. Ferrell BR, Novy D, Sullivan MD, Banja J, Dubois MY, Gitlin MC, et al. . Ethical dilemmas in pain management. J Pain. (2001) 2:171–80. 10.1054/jpai.2001.21596
    1. Thielke S, Sale J, Reid MC. Aging: are these 4 pain myths complicating care? J Fam Pract. (2012) 61:666–70.
    1. Ersek M, Turner JA, McCurry SM, Gibbons L, Kraybill BM. Efficacy of a self-management group intervention for elderly persons with chronic pain. Clin J Pain. (2003) 19:156–67. 10.1097/00002508-200305000-00003
    1. Tse MMY, Vong SKS, Ho SS. The effectiveness of an integrated pain management program for older persons and staff in nursing homes. Arch Gerontol Geriatr. (2012) 54:e203–12. 10.1016/j.archger.2011.04.015
    1. Barlow J, Wright C, Sheasby J, Turner A, Hainsworth J. Self-management approaches for people with chronic conditions: a review. Patient Educ Couns. (2002) 48:177–87. 10.1016/S0738-3991(02)00032-0
    1. Park J, Hughes AK. Nonpharmacological approaches to the management of chronic pain in community-dwelling older adults: a review of empirical evidence. J Am Geriatr Soc. (2012) 60:555–68. 10.1111/j.1532-5415.2011.03846.x
    1. Reid MC, Papaleontiou M, Ong A, Breckman R, Wethington E, Pillemer K. Self-management strategies to reduce pain and improve function among older adults in community settings: a review of the evidence. Pain Med. (2008) 9:409–24. 10.1111/j.1526-4637.2008.00428.x
    1. Cooper K, Wilcock S. The effectiveness of peer support interventions for community-dwelling adults with chronic non-cancer pain: a systematic review protocol. JBI Database Syst Rev Implementation Rep. (2013) 11:348–60. 10.11124/jbisrir-2013-476
    1. Kawi J. Self-management and support in chronic pain subgroups: integrative review. J Nurse Pract. (2013) 9:110–5.e5. 10.1016/j.nurpra.2012.12.020
    1. Dennis C-L. Peer support within a health care context: a concept analysis. Int J Nurs Stud. (2003) 40:321–32. 10.1016/S0020-7489(02)00092-5
    1. Tse MMY, Li Y, Tang SK, Ng SS, Bai X, Lee PH, et al. . An exploration of the effectiveness of a peer-led pain management program (PAP) for nursing home residents with chronic pain and an evaluation of their experiences: a pilot randomized controlled trial. Int J Environ Res Public Health. (2020) 17:4090. 10.3390/ijerph17114090
    1. Adams G, Gulliford MC, Ukoumunne OC, Eldridge S, Chinn S, Campbell MJ. Patterns of intra-cluster correlation from primary care research to inform study design and analysis. J Clin Epidemiol. (2004) 57:785–94. 10.1016/j.jclinepi.2003.12.013
    1. Tse MMY, Ng SSM, Bai X, Lee PH, Lo R, Cheung DSK, et al. . Lesson learned from peer volunteers in a peer-led pain management program among nursing home residents. Int J Environ Res Public Health. (2019) 16:3097. 10.3390/ijerph16173097
    1. Lim SH, Chen PP, Wong CMT, Gin SFT, Wong SFE, Chan SFI, et al. . Validation of the Chinese version of pain self-efficacy questionnaire. Anesth Analg. (2007) 104:918–23. 10.1213/01.ane.0000255731.24092.a5
    1. Wang SX, Mendoza RT, Gao SS-Z, Cleeland SC. The Chinese version of the brief pain inventory (BPI-C): its development and use in a study of cancer pain. Pain. (1996) 67:407–16. 10.1016/0304-3959(96)03147-8
    1. Boey KW, Chiu H. Assessing psychological weil-being of the old-old: a comparative study of GDS-15 md GHQ-12. Clin Gerontol. (1998) 19:65–75. 10.1300/J018v19n01_06
    1. Choi KS, Stewart R, Dewey M. Participation in productive activities and depression among older Europeans: survey of health, ageing and retirement in Europe (SHARE). Int J Geriatr Psychiatry. (2013) 28:1157–65. 10.1002/gps.3936
    1. Salt E, Crofford LJ, Segerstrom S. The mediating and moderating effect of volunteering on pain and depression, life purpose, well-being, and physical activity. Pain Manag Nurs. (2017) 18:243–9. 10.1016/j.pmn.2017.04.004
    1. Tighe PJ, Riley III JL, Fillingim RB. Sex differences in the incidence of severe pain events following surgery: a review of 333,000 pain scores. Pain Med. (2014) 15:1390–404. 10.1111/pme.12498
    1. Oliva EM, Midboe AM, Lewis ET, Henderson PT, Dalton AL, Im JJ, et al. . Sex differences in chronic pain management practices for patients receiving opioids from the veterans health administration. Pain Med. (2015) 16:112–8. 10.1111/pme.12501
    1. Lai C, Leung D, Kwong E, Lee R. Factors associated with the quality of life of nursing home residents in Hong Kong. Int Nurs Rev. (2015) 62:120–9. 10.1111/inr.12152
    1. Tang SK, Tse MMY, Leung SF, Fotis T. The effectiveness, suitability, and sustainability of non- pharmacological methods of managing pain in community-dwelling older adults: a systematic review. BMC Public Health. (2019) 19:1488. 10.1186/s12889-019-7831-9
    1. Chang KL, Fillingim R, Hurley RW, Schmidt S. Chronic pain management: nonpharmacological therapies for chronic pain. FP Essent. (2015) 21:432.

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