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.
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
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