A low-literacy, pain self-management program delivered one-on-one by a health educator or in groups with lectures from experts over a period of 6 months may improve chronic pain outcomes, according to a study published in the Journal of Pain.

The researchers developed a low-literacy, 6-month pain self-management program based on both existing pain toolkits and the input of a rural, largely Hispanic population with chronic pain.

The study included low-income, primarily Hispanic participants with chronic pain (n=111). Participants were randomly assigned to receive 6 one-on-one meetings with a trained health educator in a clinic or to attend 8 group lectures by experts in the community. 

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The researchers used intention-to-treat analyses in linear mixed effects models to assess 5 secondary outcomes at 6 months: Brief Pain Inventory pain severity and interference, Patient Health Questionnaire-9, 12-Item Short Form Survey Mental Component Summary, and Tampa Scale for Kinesiophobia-11. Of the 111 participants, 67 completed the 6-month follow-up measures.

Study participants who received the one-on-one sessions had improvements on 4 measures vs 3 measures in patients who attended the group session (P <.05 for all). In intention-to-treat analyses, both groups had improvements on 4 of 5 measures (P≤.001 for all) compared with baseline, with clinically significant changes in Brief Pain Inventory pain severity and interference.

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These results warrant further study of self-management programs as a supplement to clinical management for primary care patients with chronic pain.

“Given limited access of low-income populations to nonpharmacologic interventions for chronic pain, it is vital that primary care practices offer training in practical self-management strategies to overcome the many negative effects of this disease,” the researchers wrote.


Turner BJ, Liang Y, Rodriguez N, Bobadilla R, Simmonds MJ, Yin Z. Randomized trial of a low literacy chronic pain self-management program: analysis of secondary pain and psychological outcome measures [published July 13, 2018]. J Pain. doi:10.1016/j.jpain.2018.06.010

This article originally appeared on Clinical Pain Advisor