Objectives
To describe the prevalence of pharmacological (PS) and nonpharmacological (NPS) pain
management approaches used by older adults with persistent pain, and identify characteristics
associated with use of these approaches.
Design
Population-based cohort
Setting
Urban and suburban communities in the Boston, Massachusetts area.
Participants
765 adults aged ≥64 years underwent a home interview and clinic exam. Those
reporting any persistent pain were included in this analysis (N=599).
Measurements
All prescription and non-prescription medications were recorded during the home
interview. NPS for pain management were assessed using a modification of the Pain Management
Inventory. The baseline assessment included extensive measures of pain, health and functioning.
Results
More than one third (37.5%) of participants reported using both PS and NPS
modalities. Thirty-one percent reported use of NPS alone and 11.5% used PS alone. NPS were
reported more frequently than PS (68.4% vs. 49%). Women (odds ratio (OR)=2.2,
95% confidence interval (CI)=1.26-3.82), those with knee OA (OR=3.07, 95%CI 1.6,-
5.9) and with moderate to severe pain (OR=5.02, CI-2.23,11.28) were more likely to report combined
use of both PS and NPS. Characteristics associated with individual NPS modalities varied
greatly.
Conclusion
Only one-third of older adults with persistent pain reported pain management strategies
consistent with current guidelines. Further research is required to understand reasons behind
choices, barriers to adherence and the benefits of multiple modalities used by older adults who have
persistent pain.