Effectiveness of a Dyadic Pain Management Program for Community-Dwelling Older Adults with Chronic Pain: A Cluster Randomized Controlled Trial

Background: The demand for digitally supported chronic pain management has grown. Yet, the employment of a well-structured and sustainable program for older adults is limited due to insufficient research studies involving both older adults and their informal caregivers. Objective: This cluster randomized controlled trial evaluated the effectiveness of a Dyadic Pain Management (DPM) program, with the primary outcome of pain intensity. Secondary outcomes included pain interference, pain self-efficacy, activities of daily living, pain knowledge, psychological symptoms (depression, anxiety, stress), and caregiver burden. Methods: A cluster randomized controlled trial was conducted with 150 dyads (community-dwelling older adults with chronic non-cancer pain and their informal caregivers) over 8 weeks. The intervention comprised 4 weeks of on-campus group sessions followed by 4 weeks of WhatsApp-based support, while the control group received lesson pamphlets. Outcomes were assessed at baseline (T0), week 8 (T1), and week 16 (T2). Results: Statistically significant improvements in pain outcomes were observed in the intervention group compared with the control group over follow-up. Between-group differences were significant for pain intensity (primary outcome) and pain interference, and pain self-efficacy also improved. Significant between-group differences were also observed for depression, anxiety, and stress after the intervention, and caregiver burden was lower in the intervention group at follow-up. Conclusions: These findings suggest that a dyadic, non-pharmacological pain management program with a WhatsApp-based component may support improvements in pain- and psychosocial-related outcomes among community-dwelling older adults with chronic pain and their informal caregivers.