PriMera Scientific Medicine and Public Health (ISSN: 2833-5627)

Review Article

Volume 4 Issue 5

Importance of Dyadic Approach in Managing Pain for Community-Dwelling Older Adults and their Informal Caregivers

Mimi Mun Yee Tse*, Percy Poo-See Tse, Venus Hiu Ying Ngai, Kin Pong To and Angel Shuk Kwan Tang

April 26, 2024

DOI : 10.56831/PSMPH-04-142


Chronic pain impacts the quality of life of older adults and their informal caregivers physiologically, psychologically, and financially. Therefore, this paper examines the challenges of pain management among older adults and their informal caregivers. Moreover, the Dyadic Pain Management Program (DPMP), an alternative approach that empowers older adults and their caregivers to provide friendly care, has proven effective. The DPMP aligns with various dominant welfare ideologies in different regions around the globe, which can potentially reduce social expenditure by emphasizing the role of families. Therefore, this paper advocates for the broader implementation of DPMP and reviews the existing policies managing older adults' chronic pain by addressing its advantages at the micro- and macro levels of the DPMP.

Keywords: chronic pain management; dyadic pain management program; informal caregivers; aging population; public health costs


  1. Rikard SM., et al. "Chronic pain among adults - United States, 2019-2021". MMWR Morb Mortal Wkly Rep 72.15 (2023): 379-385.
  2. Vadivelu N., et al. "Pain and Psychology-A Reciprocal Relationship". The Ochsner Journal 17.2 (2017): 173-180.
  3. Brown TT and Lee W. "The FUTUREPAIN study: Validating a questionnaire to predict the probability of having chronic pain 7-10 years into the future". PLoS ONE 15.8 (2020): e0237508.
  4. Deloitte Access Economics. "The cost of pain in Australia". (2019).
  5. Tse MMY., et al. "A Dyadic Pain Management Program for Community-Dwelling Older Adults with Chronic Pain: Study Protocol for a Cluster Randomized Controlled Trial". Int J Environ Res Public Health 19.19 (2022): 12186.
  6. Vassilev I., et al. "The articulation of neoliberalism: narratives of experience of chronic illness management in Bulgaria and the UK". Sociol Health Illn 39.3 (2017): 349-364.
  7. Yu SWK, Lo IPY and Chau RCM. "Rethinking the residual policy response: Lessons from Hong Kong older women's responses to the COVID-19 pandemic". Int Soc Work 66.2 (2023): 534-546.
  8. Cooper M. "Family Values: Between Neoliberalism and the New Social Conservatism". Brooklyn, NY: Zone Books (2017).
  9. Marty M., et al. "Quality of sleep in patients with chronic low back pain: A case-control study". Eur Spine J 17.6 (2008): 839-844.
  10. Morin CM, Gibson D and Wade J. "Self-reported sleep and mood disturbance in chronic pain patients". Clin J Pain 14.4 (1998): 311-314.
  11. McCracken LM and Iverson GL. "Disrupted sleep patterns and daily functioning in patients with chronic pain". Pain Res Manag 7.2 (2002): 75-79.
  12. Husak AJ and Bair MJ. "Chronic Pain and Sleep Disturbances: A Pragmatic Review of Their Relationships, Comorbidities, and Treatments". Pain Medicine 21.6 (2020): 1142-1152.
  13. Fine PG. "Long-Term Consequences of Chronic Pain: Mounting Evidence for Pain as a Neurological Disease and Parallels with Other Chronic Disease States". Pain Medicine 12.7 (2011): 996-1004.
  14. Bruehl S., et al. "Prevalence of clinical hypertension in patients with chronic pain compared to nonpain general medical patients". Clin J Pain 21.2 (2005): 147-153.
  15. Ducher M, Fauvel JP and Cerutti C. "Risk profile in hypertension genesis: A five-year follow-up study". Am J Hypertens 19.8 (2006): 775-780.
  16. Grachev ID, Fredrickson BE and Apkarian AV. "Abnormal brain chemistry in chronic back pain: An in vivo proton magnetic resonance spectroscopy study". Pain 89.1 (2000): 7-18.
  17. Apkarian AV., et al. "Chronic back pain is associated with decreased prefrontal and thalamic gray matter density". J Neurosci 24.46 (2004): 10410-10415.
  18. Flegge LG, Barr A and Craner JR. "Sexual Functioning Among Adults with Chronic Pain: Prevalence and Association with Pain-Related Outcomes". Pain Med 24.2 (2023): 197-206.
  19. Ratcliffe GE., et al. "Chronic pain conditions and suicidal ideation and suicide attempts: An epidemiologic perspective". Clin J Pain 24.3 (2008): 204-210.
  20. McCracken LM, Yu L and Vowles KE. "New generation psychological treatments in chronic pain". BMJ 376 (2022).
  21. Kinney RK., et al. "Prevalence of psychopathology in acute and chronic low back pain patients". J Occup Rehabil 3.2 (1993): 95-103.
  22. Jellinger KA. "The heterogeneity of late-life depression and its pathobiology: a brain network dysfunction disorder". J Neural Transm 130 (2023): 1057-1076.
  23. Rokach A., et al. "Caregivers of chronic pain patients: Their loneliness and burden". Nurs Palliat Care 1.5 (2016): 111-117.
  24. Latter S., et al. "Supporting carers to manage pain medication in cancer patients at the end of life: A feasibility trial". Palliative Medicine 32.1 (2018): 246-256.
  25. Chi NC., et al. "Family Caregiver Challenges in Pain Management for Patients with Advanced Illnesses: A Systematic Review". J Palliat Med 25.12 (2022): 1865-1876.
  26. McPherson CJ., et al. "Cancer-related pain in older adults receiving palliative care: Patient and family caregiver perspectives on the experience of pain". Pain Res Manag 18.6 (2013): 293-300.
  27. Mehta A, Chan LS and Cohen SR. "Flying blind: Sources of distress for family caregivers of palliative cancer patients managing pain at home". J Psychosoc Oncol 32.1 (2014): 94-111.
  28. Letizia M., et al. "Barriers to caregiver administration of pain medication in hospice care". J Pain Symptom Manage 27.2 (2004): 114-124.
  29. Tarter R., et al. "Pain in hospice patients with dementia: The informal caregiver experience". Am J Alzheimers Dis Other Demen 31.6 (2016): 524-529.
  30. Wittenberg-Lyles E., et al. "Exploring oral literacy in communication with hospice caregivers". J Pain Symptom Manage 46.5 (2013): 731-736.
  31. Shanmugasundaram S. "Unmet needs of the Indian family members of terminally ill patients receiving palliative care services". J Hosp Palliat Nurs 17.6 (2015): 536-543.
  32. Alea. "Working with a physiotherapist to restore movement [Internet]". (2022).
  33. Cohen SP, Vase L and Hooten WM. "Chronic pain: an update on burden, best practices, and new advances". Lancet 397 (2021): 2082-2097.
  34. Dahlhamer J., et al. " Prevalence of chronic pain and high-impact chronic pain among adults - United States, 2016". MMWR Morb Mortal Wkly Rep 67 (2018): 1001-1006.
  35. Fayaz A., et al. "Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies". BMJ Open 6.6 (2016): e010364.
  36. Grignon M, Owusu Y and Sweetman A. "The International Migration of Health Professionals". Institute for the Study of Labor (IZA) No. 6517 (2012).
  37. Polacek C., et al. "Healthcare professionals report pain management barriers across system, provider, and patient levels". Am J Manag Care 26.4 (2020): e135-e139.
  38. Endale T., et al. "Barriers and drivers to capacity-building in global mental health projects". Int J Ment Health Syst 14 (2020): 89.
  39. Hadi MA., et al. "'Treated as a number, not treated as a person': a qualitative exploration of the perceived barriers to effective pain management of patients with chronic pain". BMJ Open 7.6 (2017): e016454.
  40. World Health Organization. "Ageing and health [Internet]". World Health Organization (2022).
  41. Li Z, Tse M and Tang A. "The Effectiveness of a Dyadic Pain Management Program for Community-Dwelling Older Adults with Chronic Pain: A Pilot Randomized Controlled Trial". Int J Environ Res Public Health 17.14 (2020): 4966.
  42. Hartas D. "Neoliberalism and Family Policy in Britain”. In: Parenting, Family Policy and Children's Well-Being in an Unequal Society (Palgrave Macmillan Studies in Family and Intimate Life). Palgrave Macmillan (2014): 123-141.