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A cross-sectional survey of the perspectives of older people in the Scottish Highlands on the management of their chronic pain.

Stewart, Derek; Rushworth, Gordon; Bailey, Nicola; Pfleger, Sharon; Jebara, Tesnime; Munro, Kim; Youngson, Elaine; Wilson, Martin; MacLeod, John; Cunningham, Scott

Authors

Derek Stewart

Gordon Rushworth

Nicola Bailey

Sharon Pfleger

Tesnime Jebara

Kim Munro

Elaine Youngson

Martin Wilson

John MacLeod



Abstract

Background: Although there is evidence of suboptimal outcomes in older people with chronic pain, little emphasis has been placed on those in remote and rural settings. Objective: To describe the perspectives of older people in the Scottish Highlands on their chronic pain management. Design: Cross-sectional survey. Setting: NHS Highland, the most remote and rural geographical health board in Scotland. Subjects: Home-dwelling members of the public aged ≥70 years. Methods: Anonymised questionnaires were mailed to a random sample of 1800 older people. Questionnaire items were demographics, nature of any chronic pain, management regimens and perceived effectiveness. Validated scales were the Pain Disability Questionnaire and the Tampa Scale for Kinesiophobia. Results: Adjusted response rate was 39.3% (709/1755). One-quarter (25.0%, n = 177) were experiencing chronic pain, being more likely to live in deprived areas (P < 0.05). Median pain intensity was 6 (IQR 4–7, 10 high), causing distress (median 5, IQR 3–7). Respondents largely consulted GPs (66.1%, n = 117) with a minority (16.4%, n = 29) referred to a specialist pain clinic and few consulting other health professionals. Over three quarters (78.0%, n = 138) were receiving prescribed medicines, most commonly paracetamol, alone (35.6%, n = 63) or in combination with opioids (16.4%, n = 29). One-third (31.6%, n = 56) expressed a desire for more effective medicines; few reported using any non-pharmacological therapies. The median scores for the Pain Disability Questionnaire and Tampa Scale for Kinesiophobia were 74 (IQR 34–104.5, 150 high) and 40 (IQR 35–45, 68 high). Conclusions: Evidence of provision of appropriate integrated and person-centred chronic pain care is lacking.

Citation

STEWART, D., RUSHWORTH, G., BAILEY, N., PFLEGER, S., JEBARA, T., MUNRO, K., YOUNGSON, E., WILSON, M., MACLEOD, J. and CUNNINGHAM, S. 2020. A cross-sectional survey of the perspectives of older people in the Scottish Highlands on the management of their chronic pain. Age and ageing [online], 49(3), pages 432-438. Available from: https://doi.org/10.1093/ageing/afz181

Journal Article Type Article
Acceptance Date Dec 19, 2019
Online Publication Date Jan 23, 2020
Publication Date May 31, 2020
Deposit Date Jan 31, 2020
Publicly Available Date Jan 24, 2021
Journal Age and ageing
Print ISSN 0002-0729
Electronic ISSN 1468-2834
Publisher Oxford University Press (OUP)
Peer Reviewed Peer Reviewed
Volume 49
Issue 3
Pages 432-438
DOI https://doi.org/10.1093/ageing/afz181
Keywords Aged; Chronic pain; Questionnaire; Remote and rural; Scotland; Older people
Public URL https://rgu-repository.worktribe.com/output/843568

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