title: Peer volunteers in an integrative pain management program for frail older adults with chronic pain: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Chronic pain is common among the older population. A literature review on pain management program showed that exercise, yoga, massage therapy, Tai Chi, and music therapy could significantly reduce pain. In spite of the proven benefits of pain management programs, these intervention programs were effective only in the short term, and older adults would resume their old habits. It has been suggested that interventions comprising some type of social support have great potential to increase the participation of older adults. Therefore, we propose the inclusion of peer volunteers in an integrated pain management program to relieve pain among frail older adults. This study aims to explore the effectiveness of an integrated pain management program supplemented with peer volunteers in improving pain intensity, functional mobility, physical activity, loneliness levels, happiness levels, and the use of non-pharmacological pain-relieving methods among frail older adults with chronic pain.
  
  
  METHODS
  We intend to recruit 30 nursing home residents and 30 peer volunteers from the Institute of Active Ageing in Hong Kong in a group trial for an 8-week group-based integrated pain management program. There will be 16 sessions, with two 1-hour sessions each week.The primary outcome will be pain levels, while secondary outcomes will be assessed according to functional mobility, physical activity, loneliness levels, happiness levels, the use of non-pharmacological pain-relieving methods, and through a questionnaire for volunteers.
  
  
  CONCLUSIONS
  In view of the high prevalence of chronic pain among older adults and its adverse impacts, it is important to provide older adults with tools to control their pain. We propose the use of peer volunteers to enhance the effects of an integrated pain management program. It is expected that pain can be reduced and improvements can be achieved among older adults in the areas of physical activity, functional mobility, loneliness levels, happiness levels, and the use of non-pharmacological pain relieving methods. Using these results, we will assess the need to conduct a larger study with a randomized controlled design.
  
  
  BACKGROUND
  This trial was registered on 24 February 2014 at the Australian New Zealand Clinical Trials Registry (ANZCTR) with the trial number: ACTRN12614000195651.
authors.affiliation: School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR. mimi.tse@polyu.edu.hk.
authors.forename: Mimi Mun Yee
authors.initials: MM
authors.lastname: Tse
authors.forename: Paul Hong
authors.initials: PH
authors.lastname: Lee
authors.forename: Sheung Mei
authors.initials: SM
authors.lastname: Ng
authors.forename: Bik Kwan
authors.initials: BK
authors.lastname: Tsien-Wong
authors.forename: Suey Shuk Yu
authors.initials: SS
authors.lastname: Yeung
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059350:Chronic Pain / Q000523:psychology* / Q000628:therapy*; D055317:Evidence-Based Practice / Q000379:methods; D016330:Frail Elderly; D006240:Happiness; D006723:Hong Kong; D006801:Humans; D008132:Loneliness; D009043:Motor Activity; D009735:Nursing Homes; D059408:Pain Management / Q000379:methods*; D010379:Peer Group; D010865:Pilot Projects; D012107:Research Design; D014838:Volunteers