The effectiveness, suitability, and sustainability of non-pharmacological methods of managing pain in community-dwelling older adults: a systematic review

Author: Tang SK1, Tse MMY2, Leung SF2, Fotis T3
Affiliation: <sup>1</sup>School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong. <sup>2</sup>School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong. <sup>3</sup>School of Health Sciences, University of Brighton, Westlain House, Village Way, Brighton, BN1 9PH, UK.
Conference/Journal: BMC Public Health.
Date published: 2019 Nov 8
Other: Volume ID: 19 , Issue ID: 1 , Pages: 1488 , Special Notes: doi: 10.1186/s12889-019-7831-9. , Word Count: 264

BACKGROUND: Pain is common in older adults. To maintain their quality of life and promote healthy ageing in the community, it is important to lower their pain levels. Pharmacological pain management has been shown to be effective in older adults. However, as drugs can have various side effects, non-pharmacological pain management is preferred for community-dwelling older adults. This systematic review evaluates the effectiveness, suitability, and sustainability of non-pharmacological pain management interventions for community-dwelling older adults.

METHODS: Five databases, namely, CINHAL, Journals@Ovid, Medline, PsycInfo, and PubMed, were searched for articles. The criteria for inclusion were: full-text articles published in English from 2005 to February 2019 on randomized controlled trials, with chronic non-cancer pain as the primary outcome, in which pain was rated by intensity, using non-pharmacological interventions, and with participants over 65 years old, community-dwelling, and mentally competent. A quality appraisal using the Jadad Scale was conducted on the included articles.

RESULTS: Ten articles were included. The mean age of the older adults was from 66.75 to 76. The interventions covered were acupressure, acupuncture, guided imagery, qigong, periosteal stimulation, and Tai Chi. The pain intensities of the participants decreased after the implementation of the intervention. The net changes in pain intensity ranged from - 3.13 to - 0.65 on a zero to ten numeric rating scale, in which zero indicates no pain and ten represents the worst pain.

CONCLUSIONS: Non-pharmacological methods of managing pain were effective in lowering pain levels in community-dwelling older adults, and can be promoted widely in the community.

KEYWORDS: Aged; Chronic pain; Community-dwelling; Complementary therapy; Non-pharmacological interventions; Older adults; Systematic review

PMID: 31703654 DOI: 10.1186/s12889-019-7831-9