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Chronic disease self-management program for low back pain in the elderly.
Mitchell Haas1, Elyse Groupp, John Muench
1Center for Outcomes Studies, Western States Chiropractic College, Portland, OR 97230, USA. mhaas@wschiro.edu
Summary
The Chronic Disease Self-Management Program (CDSMP) did not significantly improve pain or general health in older adults with chronic low back pain (LBP). However, it showed potential benefits for emotional well-being and functional disability.
Area of Science:
- Gerontology
- Public Health
- Rehabilitation Medicine
Background:
- Chronic low back pain (LBP) is a prevalent condition affecting older Americans, leading to significant disability and reduced quality of life.
- Self-management programs offer a potential avenue for improving health outcomes in this population.
Purpose of the Study:
- To assess the effectiveness of Stanford's Chronic Disease Self-Management Program (CDSMP) for managing chronic low back pain (LBP) in community-dwelling seniors.
- To evaluate the impact of CDSMP on pain, disability, general health, self-efficacy, and emotional well-being.
Main Methods:
- A randomized controlled trial was conducted with 109 community-dwelling seniors (aged 60+) experiencing chronic LBP.
- Participants were assigned to either the CDSMP (one 2.5-hour session weekly for 6 weeks) or a 6-month wait-list control group.
- Outcomes, including pain, disability, general health (SF-36), self-efficacy, and emotional well-being, were assessed at 6 months.
Main Results:
- The CDSMP did not demonstrate a significant advantage over the control group for the primary outcome of pain reduction at 6 months (P = .835).
- A statistically significant benefit was observed for functional disability averaged over the 6-month study period (P = .027), but not at the 6-month follow-up (P = .278).
- The program showed a positive effect on emotional well-being (P = .037) and suggested benefits for fatigue and days with disability.
Conclusions:
- The CDSMP was not found to be superior to a wait-list control for improving pain, general health, self-efficacy, or self-care attitudes in older adults with chronic LBP.
- The program suggested potential benefits for emotional well-being, fatigue, and functional disability, particularly for individuals with higher baseline disability.
- Further research may be warranted to explore the specific components of CDSMP that contribute to these suggested benefits.