The Pain Management Life History Calendar: A Pilot Study

Pain management trajectory data that includes previous pain treatments, timing, changes, and outcomes provide crucial data for patients with chronic pain and their practitioners to use when discussing ways to optimize pain management regimens. The aim of this study was to test the use of the life history calendar method to identify pain treatments, treatment regimens, timing, and outcomes of the pain management trajectory of individuals with chronic pain, and to examine feasibility. A pilot, descriptive, methodological design was used. Settings included community-based sites such as congregate housing. Nineteen community-dwelling older adults with osteoarthritis (OA) pain of at least 1 year's duration participated. Participants were interviewed and asked to chronicle from the beginning of the OA pain to the present all of their pain treatments and treatment effects (pain outcomes and adverse events). Raters independently content analyzed the transcribed interviews to identify pain treatments, treatment groupings (regimens), and treatment effects on pain. Feasibility of patients reporting their pain management trajectories was content analyzed by identifying participant difficulty identifying pain treatments, treatment effects, treatment sequence; and difficulty discriminating between treatments, and between OA pain and other pain sources. Individual pain management trajectories were constructed that depicted chronological order of pain treatment regimens and treatment effects. Participants identified pain treatments, discriminate between treatments and between OA and other conditions, and identified treatment effects. Treatment sequence was identified, but more precise timing was generally not reported. Pain management trajectories could provide a helpful way for practitioners to discuss safe, efficacious pain management options with patients.