Trial reportThe American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry2025
Problem Adaptation Therapy for Older Adults with Chronic Pain and Negative Emotions in Primary Care (PATH-Pain): A Randomized Clinical Trial.
Trial report in The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo 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.
designRCT assessing the between-group differences during the acute (0-10 weeks) and follow-up (weeks 11-24) phase of treatment.
settingA geriatrics primary care site.
participants100 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).
interventionsPATH-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).
resultsDuring 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.
conclusionsThis 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.
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