Outcomes in treatment of pain in geriatric and younger age groups.
Chronic pain treatment outcome studies have generated conflicting information on whether geriatric (age 65+) patients (1) benefit from pain center treatment, and (2) benefit as much as do other age groups. We asked chronic pain patients to rate themselves at pain center admission and discharge on 43 scales assessing area of pain, functional status, behavioral variables, and other areas (pain center modification goals). Patients were placed into one of three age groups: "geriatric" (n = 153); "middle aged" 45 to 64 years (n = 126); and "younger" 21 to 44 years (n = 191). First, tests of geriatric improvement were performed. Next, the three groups were compared on baseline variables and on overall admission, discharge, and change scores. Change scores of the three groups were compared using analysis of covariance, followed by pairwise post hoc tests. Overall, the geriatric group improved on 42 of the 43 scales (p < .001). Geriatric improvement was significant on 37 scales, with most scales being significant at p < .001. Geriatric patients were significantly different from the other two groups on most baseline variables. Their admission scores were better than the other two groups. Geriatric improvement was not significantly different from the other two groups on 37 of the scales. Geriatric change was significantly better on two scales and significantly worse on 4 scales. Geriatric chronic pain patients are (1) distinctly different from younger chronic pain patients, (2) show significant and meaningful improvement with pain center treatment, and (3) demonstrate as great an improvement as the other age groups in the majority of measures.
Cutler
R B
RB
Department of Neurological Surgery, University of Miami School of Medicine, FL.
Fishbain
D A
DA
Rosomoff
R S
RS
Rosomoff
H L
HL
D000203:Activities of Daily Living; D000328:Adult; D000339:Affect; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D002908:Chronic Disease; D004651:Employment; D005081:Exercise Therapy; D005163:Factor Analysis, Statistical; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000145:classification / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D059408:Pain Management; D010147:Pain Measurement; D017060:Patient Satisfaction; D015397:Program Evaluation; D011788:Quality of Life; D012047:Rehabilitation Centers; D012064:Relaxation Therapy; D012720:Severity of Illness Index; D016896:Treatment Outcome