Journal
PAIN MEDICINE
Volume 17, Issue 1, Pages 64-73Publisher
OXFORD UNIV PRESS
DOI: 10.1093/pm/pnv055
Keywords
Aged; Assessment; Maladaptive Coping; Chronic Pain; Elderly; Low Back Pain; Primary Care; Chronic Low Back Pain
Categories
Funding
- Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Rehabilitation Research and Development Service
- NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES [KL2TR000146, UL1TR000005] Funding Source: NIH RePORTER
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Objective. As part of a series of articles designed to deconstruct chronic low back pain (CLBP) in older adults, this article focuses on maladaptive copinga significant contributor of psychological distress, increased pain, and heightened disability in older adults with CLBP. Methods. A modified Delphi technique was used to develop a maladaptive coping algorithm and table providing the rationale for the various components of the algorithm. A seven-member content expert panel and a nine-member primary care panel were involved in the iterative development of the materials. While the algorithm was developed keeping in mind resources available within the Veterans Health Administration (VHA) facilities, panelists were not exclusive to the VHA, and therefore, materials can be applied in both VHA and civilian settings. The illustrative clinical case was taken from one of the contributors' clinical practice. Results. We present a treatment algorithm and supporting table to be used by providers treating older adults who have CLBP and engage in maladaptive coping strategies. A case of an older adult with CLBP and maladaptive coping is provided to illustrate the approach to management. Conclusions. To promote early engagement in skill-focused treatments, providers can routinely evaluate pain coping strategies in older adults with CLBP using a treatment algorithm.
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