Treating Pain to Reduce Disability Among Older Home Health Patients

Visiting Nurse Service of New York

Status: Completed

Conditions: Arthritis - Post Surgical; Other Activity-limiting Pain

Treatments: Behavioral: Cognitive-Behavioral Pain Self-management Program

Study type: Interventional

Funder types: Other; Other U.S. Federal agency

Identifiers

NCT01614340

1R01HS020648-01A1

Details and patient eligibility

About

The overall goal of this real-world comparative effectiveness research (CER) study is to reduce disability among older home health patients by treating their pain more effectively. To achieve this goal the investigators will conduct a cluster randomized controlled trial of a physical therapist (PT) delivered intervention provided to VNSNY home health care patients with activity-limiting pain. The intervention is an evidence-based non-pharmacological program to reduce pain and pain-related disability that utilizes cognitive-behavioral pain self-management (CBPSM) techniques.

Full description

This project will compare the effectiveness of usual care provided to older home health patients admitted with activity-limiting pain to usual care plus instruction by PTs in CBPSM techniques. The project also will examine differences in the effectiveness of the intervention among different race/ethnicity groups and individuals with different pain types, as well as the fidelity of intervention-group PTs to the CBPSM program.

The specific aims of this CER study that will include sizeable numbers of Hispanics, non-Hispanic African Americans and non-Hispanic white patients ages 55 and older are: (1) to compare the effectiveness of usual care provided to older home health patients admitted with activity-limiting pain to usual care plus instruction by PTs in CBPSM techniques; and (2) to examine the heterogeneity of CBPSM treatment effects among patients with different pain conditions and minority group status.

Enrollment: 658 patients

Sex: All

Ages: 55+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• VNSNY patient in the adult home healthcare program
• Services are being provided in the Bronx, Brooklyn, Manhattan, Queens, Staten Island, Nassau or Westchester
• VNSNY Plan of Care includes physical therapy
• Age 55 or older
• Speaks English
• Has a telephone
• Activity-limiting pain

Exclusion criteria

• Significant cognitive impairment

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Single Group Assignment

Masking: Double Blind

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658 participants in 2 patient groups

Usual Care

Other group

Description:

Usual Physical Therapy Plan of Care

Treatment:

Behavioral: Cognitive-Behavioral Pain Self-management Program

Usual Care Plus Pain Management Program

Other group

Description:

Behavioral: Cognitive-Behavioral Pain Self-management Program.

Treatment:

Behavioral: Cognitive-Behavioral Pain Self-management Program