Identification of pain-reduction strategies used by community-dwelling older persons

Abstract

Background: The types of methods used by older persons to reduce chronic pain have not been adequately characterized. In this cross-sectional study of older persons with chronic nonmalignant pain, we sought to identify strategies perceived as effective in reducing pain and to ascertain factors associated with their use.

Methods: Participants included 272 community-dwelling persons aged 73 years or older. Information regarding participants' sociodemographic, clinical, psychological, and pain status was collected. Strategies perceived as effective in reducing pain were identified using a qualitative approach. Similar methods (e.g., "takes acetaminophen when necessary" and "uses Tramadol daily") were grouped into specific pain-reduction categories (e.g., analgesic medication use). Logistic regression analysis was used to identify associations between participant-related factors and the four most prevalent pain-reduction strategies.

Results: Participants had a mean (standard deviation) age of 80.9 (5.1) years and were mostly female (69%). Overall, 248 (91%) participants reported at least one effective strategy for reducing pain; the mean number of strategies per participant was 2.7 (range = 1-6). The four most prevalent pain-reduction strategies were analgesic medication use (reported by 59% of participants), activity restriction (38%), hot and/or cold modalities (28%), and exercise (23%). Although most participants reported at least one effective pain-reduction strategy, 60% rated their pain as "quite a bit" or "extremely" bothersome. In logistic regression analysis, no factor (including age and gender) was independently associated with any of the prevalent pain-reduction strategies.

Conclusions: Despite the fact that most participants perceived several pain-reduction strategies as effective, 60% reported experiencing substantial pain. Research of older persons with chronic pain is warranted to determine whether changes in the way existing pain-reduction strategies are administered can improve the management of pain or if more efficacious strategies are needed.