scholarly journals Development of a Smartphone Application for the Treatment of Chronic pain in Older adults based on the Daily life experience of Pain Ecological monitoring and management app for chronic pain in older adults - EMMA: Protocol for the EMMA design and feasibility study (Preprint)

2021 ◽  
Author(s):  
Katharina Ledermann
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Older People ◽  
Chronic Conditions ◽  
Daily Life ◽  
Ecological Monitoring ◽  
Cognitive Behavioral ◽  
Self Management ◽  
Trial Period ◽  
Management Interventions

BACKGROUND Chronic pain is a complex problem for many older adults that affects both physical functioning and psychological well-being. Mobile health (mHealth) technologies have shown promise in supporting older persons in managing chronic conditions. Cognitive behavior therapy (CBT) is recommended for older people with chronic pain. However, online treatment programs for chronic pain are not aimed at the needs of older people and offer standard therapies without providing tailored treatment for this population. OBJECTIVE To address this problem, we will develop a psychological internet-based intervention based on ecological monitoring of daily life experiences with chronic pain, called EMMA to support self-management of chronic pain in older adults. METHODS The key clinical and engagement features of the intervention were established through the integration of evidence-based material from cognitive behavioral therapy for the treatment of chronic pain in older adults. The development process uses a CoDesign approach and actively involves the end-users in the design process by incorporating feedback from focus groups with older adults in order to inform a user centered intervention design. For the CoDesign process, we will include 10 older adults without chronic pain that will discuss the requirements in workshops in order to ensure suitability for older adults. In order to test the feasibility and acceptability of the intervention, we will include a sample of 30 older adults with chronic pain that will test all features of the intervention for a period of eight consecutive weeks. After the trial period, validated instruments to assess usability and acceptability, as well as influence on pain levels and associated physical and psychological symptoms will be filled out by the participants. Participants will be invited to take part in a semi-structured telephone interview after the trial period to explore their experiences using the app. Required changes to assure usability and acceptability will afterwards directly implemented in the application. RESULTS EMMA brings together a strong body of evidence using cognitive behavioral and self-management theory with contemporary mHealth principles, allowing for a cost-effective intervention irrespective of place and time to target chronic pain in older adults. CONCLUSIONS Given the ubiquity of mHealth interventions for chronic conditions, the results of this study may serve to inform the development of tailored pain self-management interventions.

scholarly journals CHRONIC PAIN SELF-MANAGEMENT PRACTICES AND PREFERENCES AMONG URBAN AFRICAN AMERICAN OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S70-S70
Author(s):  
Mary R Janevic ◽  
Mary Janevic ◽  
Sheria Robinson-Lane ◽  
Susan Murphy ◽  
John Piette
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
African American ◽  
Pain Management ◽  
Focus Group ◽  
Management Practices ◽  
Pilot Trial ◽  
Self Management ◽  
Management Interventions ◽  
African American Older Adults

Abstract African American older adults experience disproportionate burden from disabling chronic pain. Pain self-management interventions for this group are most effective when they integrate culturally-relevant preferences into intervention design. In the STEPS pilot trial, we collected focus group (n=23) and survey (n=57) data from African Americans age 60+ years about pain-management practices. Participants were recruited from the community and reported pain for 3+ months, with intensity >4 (0 to 10 scale). The most frequently-used pain-management strategies were exercise (75%) and prayer/Bible reading (74%). Also commonly used were healthy eating (61%), OTC medications (65%), and herbal supplements (51%). Focus group themes provided more nuanced information, including reasons for avoiding prescription pain medications, positive experiences with topical treatments, the value of movement, and the role of social support. Findings reveal strong engagement in pain self-care in this population. Interventions can build on existing practices by incorporating spirituality and appealing options for physical activity.

scholarly journals PROMOTING SUCCESSFUL CHRONIC DISEASE SELF-MANAGEMENT THROUGH COMMUNITY-BASED INTERVENTIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S68-S69
Author(s):  
Tiffany R Washington ◽  
Laura N Gitlin ◽  
Matthew L Smith
Keyword(s):  
Older Adults ◽  
Chronic Disease ◽  
Chronic Conditions ◽  
Health Management ◽  
Negative Impact ◽  
Self Management ◽  
Community Based Interventions ◽  
Community Based ◽  
Factors Affecting ◽  
Management Interventions

Abstract Persistent chronic conditions are among the top leading causes of death in the U.S. The majority of older adults live with two or more chronic conditions. When poorly managed, chronic conditions can result in negative psychosocial and health outcomes such as low quality of life, diminished mood, workforce withdrawal, high healthcare utilization, and disability. Fortunately, chronic disease self-management interventions show promise in reducing the negative impact of chronic conditions on health status. This symposium will highlight formative work and recent findings of community-based interventions that promote successful self-management. To start, presenter one will describe findings from four studies that constitute the formative work necessary to inform implementation of self-management interventions in community and healthcare settings. Next, presenter two will report findings from an effectiveness trial of a technology-based intervention to support hypertension self-management. Then, presenter three will describe findings on the feasibility of a Health Passport tool to promote self-health management among individuals with physical limitations. Finally, presenter four will describe factors affecting attendance among African Americans with arthritis who participated in a national dissemination of Chronic Disease Self-Management Education programs. Collectively, these presentations will provide practical evidence and science-based recommendations for ways to increase successful chronic disease self-management and ultimately improve population health among older adults.

scholarly journals Engaging with EPIO, a digital pain self-management program: A qualitative study

2021 ◽  
Author(s):  
Katrine Bostrøm ◽  
Cecilie Varsi ◽  
Hilde Eide ◽  
Elin Børøsund ◽  
Olof B Kristjansdottir ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Intervention Program ◽  
Management Program ◽  
Cognitive Behavioral ◽  
Phone Call ◽  
Self Management ◽  
Structured Interviews ◽  
Management Intervention ◽  
Management Interventions ◽  
Chronic Pain Conditions

Abstract Background:Chronic pain conditions entail significant personal and societal burdens and improved outreach of evidence-based pain self-management programs are needed. Digital cognitive-behavioral self-management interventions have shown promise. However, evidence is still scarce and several challenges with such interventions for chronic pain exist. Exploring patients' experiences and engagement with digital interventions may be an essential step towards developing meaningful digital self-management interventions for those living with chronic pain. Objectives:This study aimed to gain insight into the experiences of people with chronic pain when engaging with EPIO, an application (app)-based cognitive-behavioral pain self-management intervention program.Methods: Participants (N=50) living with chronic pain received access to the EPIO intervention for 3 months. During this time, all participants received a follow-up phone call at 2-3 weeks, and a subsample (n=15) also participated in individual semi-structured interviews after 3 months. A qualitative design was used and thematic analysis was employed aiming to capture participants’ experiences when engaging with the EPIO intervention program. Results:Findings identifying program-related experiences and engagement were organized into three main topics, each with three sub-themes: (1) Engaging with EPIO; motivation to learn, fostering joy and enthusiasm, and helpful reminders and personalization, (2) Coping with pain in everyday life; awareness, practice and using EPIO, and (3) The value of engaging with the EPIO program; EPIO – a friend, making peace with the presence of pain, and fostering communication and social support. Conclusions: The current study explored participants’ experiences and engagement with EPIO, a digital self-management intervention program for people living with chronic pain. Findings highlighted identifying valued aspects related to motivation for engagement, incorporating content in support of daily coping, and encouraging a sense of acceptance and relatedness as vital components for facilitating program engagement.Trial Registration: ClinicalTrials.gov NCT03705104; https://clinicaltrials.gov/ct2/show/NCT03705104

scholarly journals The Role of Pets in Supporting Cognitive-Behavioral Chronic Pain Self-Management: Perspectives of Older Adults

2019 ◽  
Vol 39 (10) ◽  
pp. 1088-1096 ◽  
Author(s):  
Mary R. Janevic ◽  
Varick Shute ◽  
Cathleen M Connell ◽  
John D. Piette ◽  
Jenna Goesling ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Behavioral Activation ◽  
Management Strategies ◽  
Cognitive Behavioral ◽  
Self Management ◽  
Pet Ownership ◽  
Mood Management ◽  
Negative Impacts ◽  
Pain Testing

Cognitive-behavioral self-management strategies are recommended for older adults with chronic pain. The goal of this study was to explore how pet ownership promotes use of these strategies in everyday life. We conducted four focus groups ( N = 25) with dog and cat owners aged ≥70 years with persistent pain. Participants described how their pets affect their daily routines and health, including pain and its management. We analyzed transcripts for salient themes, categorizing them according to their alignment with recommended pain self-management strategies: Mood Management (e.g., increases positive affect), Relaxation/Distraction (e.g., soothing presence), Physical Activity (e.g., dog-walking), Behavioral Activation (e.g., motivates activity even when pain present), Social Activation (e.g., facilitates socializing), and Sleep (e.g., encourages routine). Some participants described negative impacts of pet ownership. Having pets can facilitate behaviors and thoughts that may enhance coping with pain. Testing formal ways of leveraging pets’ role may expand nonpharmacological options for chronic pain management.

scholarly journals Unintended Consequences of Opioid Regulations in Older Adults with Multiple Chronic Conditions

2020 ◽  
Vol 60 (7) ◽  
pp. 1343-1352 ◽  
Author(s):  
Christine S Ritchie ◽  
Sarah B Garrett ◽  
Nicole Thompson ◽  
Christine Miaskowski
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Pain Management ◽  
Chronic Conditions ◽  
Unintended Consequences ◽  
Self Management ◽  
Multiple Chronic Conditions ◽  
Opioid Epidemic ◽  
Management Options ◽  
Policy Responses

Abstract Background and Objectives The opioid epidemic has led to substantive regulatory and policy changes. Little is known about how these changes have impacted older adults, especially those with chronic pain and multiple chronic conditions (MCC). We sought to understand the experiences of older adults with chronic pain and MCC in the context of the opioid epidemic and policy responses to it. Research Design and Methods Purposive sampling of older adults in a West Coast metropolitan area. Semistructured in-depth interviews lasting 45–120 min were digitally recorded and transcribed. Responses were analyzed using the constant comparative method. Participants were 25 adults aged 65 years and greater with three or more self-reported medical conditions and pain lasting for more than 6 months. Results Respondents’ accounts revealed numerous unintended consequences of the opioid epidemic and its policy responses. We identified four main themes: changes to the patient–clinician relationship; lack of patient agency and access in pain management; patient ambivalence and anxiety about existing opioid treatment/use; and patient concerns about future use. Discussion and Implications Older adults have high rates of chronic pain and MCC that may reduce their pain management options. The opioid epidemic and policies addressing it have the potential to negatively affect patient–clinician relationships and patients’ pain self-management. Clinicians may be able to mitigate these unintended consequences by actively conveying respect to the patient, empowering patients in their pain self-management activities, and proactively addressing worries and fears patients may own related to their current and future pain management regimens.

scholarly journals Effectiveness of an eHealth self-management tool for older adults with multimorbidity (KeepWell): protocol for a hybrid effectiveness–implementation randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e048350
Author(s):  
Monika Kastner ◽  
Julie Makarski ◽  
Leigh Hayden ◽  
Jemila S Hamid ◽  
Jayna Holroyd-Leduc ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Disease ◽  
Randomised Controlled Trial ◽  
Disease Management ◽  
Chronic Conditions ◽  
Controlled Trial ◽  
Management Tool ◽  
Self Management ◽  
Plain Language ◽  
Randomised Controlled

IntroductionIn response to the burden of chronic disease among older adults, different chronic disease self-management tools have been created to optimise disease management. However, these seldom consider all aspects of disease management are not usually developed specifically for seniors or created for sustained use and are primarily focused on a single disease. We created an eHealth self-management application called ‘KeepWell’ that supports seniors with complex care needs in their homes. It incorporates the care for two or more chronic conditions from among the most prevalent high-burden chronic diseases.Methods and analysisWe will evaluate the effectiveness, cost and uptake of KeepWell in a 6-month, pragmatic, hybrid effectiveness–implementation randomised controlled trial. Older adults age ≥65 years with one or more chronic conditions who are English speaking are able to consent and have access to a computer or tablet device, internet and an email address will be eligible. All consenting participants will be randomly assigned to KeepWell or control. The allocation sequence will be determined using a random number generator.Primary outcome is perceived self-efficacy at 6 months. Secondary outcomes include quality of life, health background/status, lifestyle (nutrition, physical activity, caffeine, alcohol, smoking and bladder health), social engagement and connections, eHealth literacy; all collected via a Health Risk Questionnaire embedded within KeepWell (intervention) or a survey platform (control). Implementation outcomes will include reach, effectiveness, adoption, fidelity, implementation cost and sustainability.Ethics and disseminationEthics approval has been received from the North York General Hospital Research and Ethics Board. The study is funded by the Canadian Institutes of Health Research and the Ontario Ministry of Health. We will work with our team to develop a dissemination strategy which will include publications, presentations, plain language summaries and an end-of-grant meeting.Trial registration numberNCT04437238.

scholarly journals The Situated Influence of Chronic Pain Perception on Chinese Older Adults’ Self-Management in Home Care

Geriatrics ◽  
2018 ◽  
Vol 3 (4) ◽  
pp. 64
Author(s):  
Fang Liu ◽  
Min Tong
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Chronic Disease ◽  
Pain Perception ◽  
Community Dwelling ◽  
Self Management ◽  
Chinese Older Adults ◽  
Care Experience ◽  
Management Capacity ◽  
Important Others

Background and objective: Worldwide, 26 million older adults die from chronic disease, and chronic pain is typically a part of the experience of chronic disease. This study explores the perception of chronic pain for home-dwelling Chinese older adults and its influence on (1) self-management ability and (2) management and reduction of chronic pain. Methods: Adopting a qualitative study design, we conducted in-depth interviews with 10 Chinese community-dwelling older adults who experience chronic pain. Half of our informants perceive chronic pain, whereas the other half, diagnosed with Alzheimer’s disease, do not report that they perceive chronic pain. Data were analyzed with inductive thematic analysis. Results: Chronic pain perception plays important roles in (1) defining the challenge of self-management, (2) connecting previous caretaking experience, (3) adjusting the identity of self-management, (4) acquiring support from important others and (5) re-planning self-management arrangements. Conclusion: Pain perception helps to motivate Chinese older adults to face health challenges and regain self-management capacity through adjustments in self-identity and care experience with the support of important others. Pain perception can consolidate the situation of independent living of older adults. It helps to motivate Chinese older adults to face health challenges and regain self-management capacity.

scholarly journals PSYCHOSOCIAL AND CULTURAL PAIN EXPERIENCES AND SELF-MANAGEMENT ACROSS DIVERSE OLDER ADULT POPULATIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S70-S70
Author(s):  
Staja Booker ◽  
Keesha Roach
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Older Adult ◽  
Bodily Pain ◽  
Cultural Factors ◽  
Qualitative Inquiry ◽  
Mediating Effect ◽  
Self Management ◽  
Osteoarthritis Pain ◽  
Racial Ethnic

Abstract Racial/ethnic minority older adults experience a disproportionate burden of functionally-disabling chronic pain. However, minimal research in pain and aging has fully explicated the unique and endemic psychosocial and cultural factors that strongly influence appraisal, communication, and management/coping of pain. Yet, to fully engage with and care for diverse racial/ethnic older adults, intentional responsiveness to these factors is necessary. This symposium features under-represented racial/ethnic older adult populations and multiple methodologies, including advanced imaging techniques, to understand various psychosocial and cultural factors associated with chronic pain. Our first presenter, Dr. Lor, uses qualitative inquiry to examine pain-associated language and expression of pain in Hmong older adults, which is often laden with stress and misunderstanding. Following is Dr. Taylor who will discuss the mediating effect of stress and coping on bodily pain in inner-city Black older adults. Dr. Terry will present novel findings on the association between catastrophizing (i.e., negative cognitive and emotional response to actual or anticipated pain resulting in feelings of helplessness) and brain structure in non-Hispanic Black and White adults with or at high-risk for knee osteoarthritis pain. This presentation will segway into culturally-relevant pain self-management practices and the role of social support specifically for Blacks from urban Detroit, as presented by Dr. Janevic. We will conclude with Dr. Booker presenting mixed-level data on the lack of familial and social networks and provider support for osteoarthritis pain self-management in Southern-dwelling older Blacks. This symposium extends the knowledge on the nuanced complexity of biopsychosocial and cultural dynamics underlying the pain experience.

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