Implementing a Pain Self-Management Protocol in Home Care: A Cluster-Randomized Pragmatic Trial.

Objectives: To determine the effectiveness of a cognitive-behavioral pain self-management (CBPSM) protocol delivered by physical therapists (PTs) for use by older adults with activity-limiting pain receiving home care.

Design: A randomized pragmatic trial comparing delivery of the intervention plus usual care with usual care alone.

Setting: Community.

Translating Evidence-Based Protocols Into the Home Healthcare Setting.

Activity-limiting pain is common among older home care patients and pain management is complicated by the high prevalence of physical frailty and multimorbidity in the home care population. A comparative effectiveness study was undertaken at a large urban home care agency to examine an evidence-based pain self-management program delivered by physical therapists (PTs). This article focuses on PT training, methods implemented to reinforce content after training and to encourage uptake of the program with appropriate patients, and therapists' fidelity to the program.

Pain and Function in Home Care: A Need for Treatment Tailoring to Reduce Disparities?

Objectives: To describe racial/ethnic group differences in pain presentation and the prevalence of psychosocial factors among patients admitted to home health care, and to determine the extent of racial/ethnic group differences in the association of psychosocial factors with pain intensity and pain-related disability.

Methods: We analyzed cross-sectional data on 588 patients with activity-limiting pain admitted to home care for physical therapy. Three psychosocial factors were assessed: depressive symptoms, pain self-efficacy, and health literacy.