The effect of Stanford-type self-management programmes on pain and function in older people with persistent pain

Self-management is advocated for older people with persistent pain. Self-management can be used to describe a range of approaches. Of these, the model developed at Stanford University is one of the most well known. To examine claims of the effectiveness of this approach for pain and function in older people we carried out a systematic review of randomised controlled trials. Trials were included in which participants were aged at least 65 years old and living in the community with persistent pain; the intervention arm was the Stanford model or a close derivative; and measures were taken of pain severity, and/or physical function and/or psychological function at a follow up of at least 6 months. Studies were excluded if the sample also contained people younger than 65 years old or if they were in a language other than English. Three RCTs were identified, each rated as moderate quality. Analysis showed a lack of convincing evidence in support of the Stanford model of self-management or close derivatives, as delivered in the trials, for reducing pain severity or improving function in people over 65 years old with persistent pain.