Effectiveness of Interdisciplinary Pain Management Programs in Elderly Populations
Huber, Elizabeth Gray
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BACKGROUND: Chronic pain is a debilitating disease that affects millions of adults in the United States. In recent years, there has been a steady increase in the use of interdisciplinary interventions to treat chronic pain. While the effectiveness of such programs is well-documented in adult populations, little is known about the efficacy of such methods for elderly populations. OBJECTIVE: This study assessed the effectiveness of an interdisciplinary pain management program in addressing chronic pain and associated disability (e.g., loss of functioning, poor mood) in the elderly. Study aims also included a comparison of outcomes between elderly and non-elderly participants in an interdisciplinary pain management program, as well as an examination of which variables may serve as predictors for completion of such programs. METHOD: Participants included one hundred and thirteen chronic pain patients receiving treatment in an interdisciplinary program at the Eugene McDermott Center for Pain Management. Participants completed multiple measures pertaining to pain and associated conditions at baseline, mid-way through the program (2 weeks post-enrollment) and upon completion of the program (4 weeks post-enrollment). ANALYSIS: Repeated measures ANOVA analyses examined changes in participants’ scores over time on various self-report measures that assessed pain rating, functionality and mood. Separate analyses were conducted to evaluate results from elderly participants only, and then to compare results between elderly and non-elderly participants. A binomial logistic regression was performed to determine the effects of age and mood on the likelihood that participants in an interdisciplinary pain management program would complete treatment in the program. RESULTS: Although elderly participants’ mean scores across a variety of measures showed signs of improvement, these changes did not meet statistical significance. However, when examining elderly and non-elderly participants together, both groups demonstrated significant improvement across all outcomes with the exception of depression. There were group differences on a select number of outcomes, including those that assessed pain disability, anxiety and depression levels; on these measures, the mean scores for non-elderly participants were higher as compared to elderly participants. There were no interactions between the two groups for any of the variables assessed. The logistic regression model that examined the effects of age and mood on the likelihood that participants would complete treatment in the current study was not significant. DISCUSSION: The current study demonstrates that non-elderly participants experience benefit from participation in interdisciplinary pain management programs. Further research is warranted with a larger elderly population to assess how treatment may need to be tailored to the unique needs of the elderly.