Self-management of pain in older persons: helping people help themselves.

OBJECTIVE

This article has the following two primary objectives: 1) to provide a discussion of the self-management of pain for older adults in relation to therapist-assisted cognitive behavioral procedures; and 2) to review the main features of a recently developed manualized pain self-management program for older adults.

DESIGN

Literature review.

RESULTS

The term self-management has been used loosely in the pain literature to describe a wide variety of programs in which the individual plays an active role in the management of his or her pain. Many of these programs are therapist-/facilitator-assisted and have many commonalities with cognitive behavior therapy. Efficacy evidence for self-management in older adults is mixed although arthritis self-management programs show considerable promise. The incorporation of a therapist/facilitator appears to enhance the effects of self-management programs.

CONCLUSIONS

Self-management outcomes may be inconsistent across studies partly because there is very limited standardization and manualization of self-management approaches. A manualized self-management program is described as an example of an approach that could easily be standardized and facilitate future investigations. It would be important for subsequent research to focus on the identification of subgroups of older patients who are most likely to benefit from self-management, and to determine whether self-management improves outcomes of future professionally administered treatments.