Effectiveness of a dyadic pain management program for community-dwelling older adults with chronic pain: a cluster randomized controlled trial (Preprint)

BACKGROUND The demand for digital-supported chronic pain management has grown, especially since the COVID-19 pandemic. Yet, the employment of a well-structured and sustainable program for older adults is limited due to insufficient research studies involving both older adult participants and their informal caregivers. OBJECTIVE This study aimed to test the effectiveness of the Dyadic Pain Management (DPM) in reducing pain, psychological health symptoms, and improving pain self-efficacy, physical well-being, and quality of life. Besides, this study evaluated the efficacy of the digital component of the DPM in increasing older adults’ engagement in managing pain individually, despite the social distancing restrictions. METHODS A cluster randomized controlled trial was conducted with socially vulnerable older adults (n=75) and their informal caregivers (n=75) for 8 weeks, which involved 4 weeks of on-campus activities and another 4 weeks of WhatsApp-based activities. The design of the intervention was based on the Pender’s Health Promotion Model, with the purpose to equip participants with essential knowledge and skills to manage their pain individually. After recruitment, participants were randomly placed into the experimental group that received the intervention, and control group which received lesson pamphlets. The evaluation of pain situation, physical and psychological health, caregiver burden inventory, and a semi-structured interview were conducted before the intervention (T0), at week 8 (T1), and week 16 (T2). RESULTS The results showed that participants’ pain situation was significantly improved. The between group P values for pain self-efficacy, pain intensity, and pain interference were P<.001, P=.003, and P<.001, respectively. Additionally, the differences in depression (P=.004), anxiety (P=.010), and stress (P=.021) were significant between the two groups after the intervention. Finally, caregiver burden was significantly reduced after the intervention, where it was P=.008 for the experimental group and P=.001 for differences between groups. CONCLUSIONS The findings implied the effectiveness of non-pharmacological chronic pain methods integrated with a digital add-on for community-dwelling older adults and their informal caregivers. CLINICALTRIAL ClinicalTrials.gov NCT05056623 INTERNATIONAL REGISTERED REPORT RR2-DOI: 10.3390/ijerph191912186