Problem Adaptation Therapy for Older Adults with Chronic Pain and Negative Emotions in Primary Care (PATH-Pain): A Randomized Clinical Trial. Kiosses DN, et al, Am J Geriatr Psychiatry 2025.
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Résumé et points clés
Objective: To test the efficacy of Problem Adaptation Therapy for Pain (PATH-Pain) versus Usual Care (UC) in reducing pain-related disability, pain intensity, and depression among older adults with chronic pain and negative emotions.
Design: RCT assessing the between-group differences during the acute (0-10 weeks) and follow-up (weeks 11-24) phase of treatment.
Setting: A geriatrics primary care site.
Participants: 100 participants (80 % females, Mean Age = 75.5) with chronic pain, negative emotions, and varying cognition (56 % had cognitive impairment) were randomly assigned to PATH-Pain (N = 49) or UC (N = 51). INTERVENTIONS: PATH-Pain is a collaborative program which includes a psychosocial intervention designed to improve emotion regulation. UC participants received a booklet that described evidence-based self-management pain strategies.
Measurements: Primary
Outcomes: Pain-related disability (Modified Roland-Morris Disability Questionnaire), and pain intensity. SECONDARY
Outcomes: Depression (Montgomery-Asberg Depression Rating Scale), emotion regulation (Emotion Regulation Questionnaire), and treatment satisfaction (Client Satisfaction Questionnaire).
Results: During acute treatment (by Week 10), PATH-Pain vs. UC participants showed a significant decrease in pain-related disability [contrast mean difference (CMD) = -1.96, P = 0.02), CI [-0.47, -3.44]] and in depression severity (CMD = -2.50, P = 0.03, CI [-.0.23, -4.76]), but not in pain intensity. PATH-Pain (vs. UC) participants also demonstrated a significant improvement in expressive suppression, an aspect of emotion regulation (CMD = 2.120, P = 0.010, CI [.085, 4.155]). During follow-up (Week 11 to 24), there were no significant between-group differences in pain-related disability, pain intensity, or depression severity.
Conclusions: This primarycarebased study demonstrates the short-term efficacy of PATH-Pain versus UC in reducing pain-related disability and depression in older adults with comorbid chronic pain and negative emotions, as well as varying degrees of cognitive functioning.
Références de l'article
- Problem Adaptation Therapy for Older Adults with Chronic Pain and Negative Emotions in Primary Care (PATH-Pain): A Randomized Clinical Trial.
- Problem Adaptation Therapy for Older Adults with Chronic Pain and Negative Emotions in Primary Care (PATH-Pain): A Randomized Clinical Trial.
- Kiosses DN, Ravdin LD, Banerjee S, Wu Y, Henderson CRJ, Pantelides J, Petti E, Maisano J, Meador L, Kim P, Vaamonde D, Reid MC
- The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
- 2025
- Am J Geriatr Psychiatry. 2025 Apr;33(4):345-357. doi: 10.1016/j.jagp.2024.12.008. Epub 2025 Jan 6.
- Humans, Female, Aged, Male, *Chronic Pain/therapy/psychology/complications, Primary Health Care, *Depression/therapy, Aged, 80 and over, *Emotional Regulation, *Pain Management/methods, Pain Measurement, *Psychosocial Intervention/methods
- Syndromes_Geriatriques, Douleur, Dépression, Ambulatoire
- Liens
- Traduction automatique en Français sur Google Translate
- DOI: 10.1016/j.jagp.2024.12.008
- PMID: 39875212
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