Perceived barriers to trying self-management approaches for chronic pain in older persons

OBJECTIVES: To examine older persons' willingness to participate in exercise and relaxation programs for managing chronic pain, to identify characteristics associated with willingness to participate, and to ascertain their barriers to participation. DESIGN: Cross-sectional survey. SETTING: A geriatric ambulatory care practice located in New York, New York, and the General Clinical Research Center of Weill Cornell Medical College. PARTICIPANTS: Sixty-eight English-speaking patients aged 70 and older with chronic pain. MEASUREMENTS: Participants' level of willingness to participate in the programs was assessed using 5-point Likert scales, and information regarding their demographic, clinical, psychological, and pain status was obtained. Qualitative methods were used to ascertain participants' perceived barriers to participation. RESULTS: Participants had a mean age +/- standard deviation of 81.9 +/- 7.0 and were mostly white (85%) and female (68%). Although only 16% of participants reported current use of exercise as a pain-management strategy, 73% reported a willingness to try the exercise program. Four percent reported current use of relaxation methods; 70% reported an interest in learning these techniques. Moderate correlations were found between increasing days of restricted activity due to pain and greater willingness to participate. Seventeen unique barriers were identified; the mean number of barriers reported per person was 2.9 +/- 1.8 for exercise and 2.2 +/- 1.4 for relaxation. Commonly reported barriers to participating in either program included time conflicts, transportation, treatment efficacy concerns, and fear of pain or injury. CONCLUSION: Older primary care patients with chronic pain are willing to try exercise and relaxation therapies to help manage pain but report a substantial number of barriers to participating in these programs. Addressing patient-level barriers could improve engagement in and adherence to exercise and relaxation therapies for managing pain in older persons.