It is no secret that many older patients with common chronic conditions also report chronic pain. This may be the result of a number of factors ranging from arthritis to the normal wear and tear of aging. Krein and coworkers looked at how chronic pain affected the difficulty patients had with recommended self-management activities, and the intervening role of self-efficacy (the confidence one has in his or her ability to perform a specific task) in doing these tasks. Data were obtained from a nationwide survey of older patients, primarily older men, with chronic health conditions. Chronic pain was defined as pain that was present most of the time for 6 months or more during the past year. The researchers assessed ability to follow self-management recommendations by asking respondents to rate their level of difficulty in performing three commonly recommended activities as suggested by their doctor. Results showed that more than 60% of respondents reported chronic pain. Chronic pain was significantly associated with difficulty exercising regularly and taking prescribed medications, but not with following a recommended eating plan. However, when self-efficacy was taken into account, chronic pain was no longer significantly associated with either exercise or taking medications.

COMMENTS: Chronic pain is prevalent among older patients and is associated with greater reported difficulty doing certain self-management activities. Self-efficacy, however, plays an important role. According to Krein and coworkers, higher self-efficacy reduced the association between chronic pain and reported difficulty exercising and taking medications. These findings are similar to those found throughout the self-management literature. Self-efficacy insures that patients, including older adults with multiple chronic health problems, perform self-management recommendations.

S.L. Krein et al. Overcoming the influence of chronic pain on older patients' difficulty with recommended self-management activities. Gerontologist, 2007;47:61-68.