Treating Pain to Reduce Disability Among Older Home Health Patients
- Conditions
- Arthritis - Post SurgicalOther Activity-limiting Pain
- Interventions
- Behavioral: Cognitive-Behavioral Pain Self-management Program
- Registration Number
- NCT01614340
- Lead Sponsor
- Visiting Nurse Service of New York
- Brief Summary
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.
- Detailed 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.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 658
- 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
- Significant cognitive impairment
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Usual Care Plus Pain Management Program Cognitive-Behavioral Pain Self-management Program Behavioral: Cognitive-Behavioral Pain Self-management Program. Usual Care Cognitive-Behavioral Pain Self-management Program Usual Physical Therapy Plan of Care
- Primary Outcome Measures
Name Time Method Improvement on Performance-Based Measures of Functioning Among Intervention Patients Baseline/Intake and 60 day follow up Patients receiving usual care plus the intervention when compared with participants receiving usual care only will demonstrate (1) Significantly better results as measured by the Timed Up and Go test; Timed Chair Stands, and Timed Foot Taps test;(2) Significantly better ADL functioning;(3) Significantly reduced levels of pain-related disability as measured by the Roland Morris Disability Questionnaire; and (4) Significantly reduced levels of pain intensity and increased levels of pain relief as measured by the Brief Pain Inventory.
- Secondary Outcome Measures
Name Time Method Lower Rates of Service Utilization Within Intervention Group 60 day follow up survey Patients receiving the intervention plus usual care when compared to patients receiving usual care only will demonstrate significantly lower emergency department and hospital use during the follow-up period (as reported by the patient).
Trial Locations
- Locations (1)
Visiting Nurse Service of New York
🇺🇸New York, New York, United States