Feasibility of a mind-body activity program for English and Spanish-speaking older adults with chronic pain delivered within shared medical visits in a community clinic.

Abstract

Background and objectives: Underserved older adults with chronic pain receive pain treatment predominantly in primary care. However, these clinics often lack resources and access to evidence-based psychosocial pain management. Shared medical visits, in which patients receive care in a group setting, offer a practical avenue for implementing psychosocial pain management. We conducted an open pilot study with exit interviews (NIH stage 1a) assessing the feasibility of GetActive+, an efficacious mind-body activity intervention for older adults with chronic pain in a community clinic delivered via shared medical visits.

Research design and methods: Twenty English-speaking and thirteen Spanish-speaking older adults with chronic pain from a community primary care clinic participated in GetActive+. Our a priori set primary outcomes were feasibility (≥ 75% of patients approached agree to participate), acceptability (≥ 75% of patients enrolled complete 8/10 sessions), and fidelity (≥ 75% of session components delivered as intended). We also assessed preliminary quantitative outcomes, including multimodal physical function (ActiGraph, PROMIS physical function, 6-minute walk test), pain intensity and interference (Brief Pain Inventory; PEG), and emotional function (depression and anxiety symptoms).

Results: We exceeded our benchmarks for feasibility (86.8%), acceptability (93.9%) and fidelity (97.9%). Participants demonstrated improvement in self-reported physical function and 6-minute walk test, pain intensity and interference, and depressive symptoms but not in ActiGraph step count or anxiety symptoms. Exit interviews supported the quantitative findings.

Discussion and implications: GetActive+ exceeded feasibility benchmarks and offers promise in making psychosocial pain management more accessible in the community via group delivery by any available provider.