Psychological Interventions Beneficial for Chronic Pain in Older Adults

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Reducing pain and improving self-efficacy for pain management are some of the benefits of psychological interventions.
Reducing pain and improving self-efficacy for pain management are some of the benefits of psychological interventions.

Patients with noncancer chronic pain can benefit from psychological interventions, according to a study published in JAMA Internal Medicine.

Bahar Niknejad, MD, of the Department of Medicine at Eastern Virginia Medical School in Norfolk, and associates conducted a systematic review and meta-analysis to understand if older adults with chronic pain would benefit from psychological therapies and the effectiveness of such treatments.

The main outcome studied was pain intensity, with secondary outcomes including pain interference, depressive symptoms, anxiety, worsening beliefs, self-efficacy for pain management, physical function, and health.

The investigators examined 22 studies involving 2608 volunteers (69% women; average age, 71.9 years). Average differences were standardized and recorded for pain intensity (dD=-0.181), pain interference (dD=-0.133), depressive symptoms (dD=-0.128), anxiety (dD=-0.205), worsening beliefs (dD=-0.184), self-efficacy (dD=-0.193), physical function (dD=0.006), and physical health (dD=0.160) at posttreatment.

The only category with evidence of persisting effects after posttreatment analysis was pain (dD=-0.251).

“Psychological interventions for the treatment of chronic pain in older adults have small benefits, including reducing pain and catastrophizing beliefs and improving pain self-efficacy for managing pain,” the authors reported.

“These results were strongest when delivered using group-based approaches. Research is needed to develop and test strategies that enhance the efficacy of psychological approaches and sustainability of treatment effects among older adults with chronic pain,” they concluded. 

Reference

Niknejad B, Bolier R, Henderson CR, et al. Association between psychological interventions and chronic pain outcomes in older adults: A systematic review and meta-analysis. [Published online May 7, 2018]. JAMA Intern Med. doi:10.1001/jamainternmed.2018.0756
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