The effect of stanford-type self-management programmes on pain and function in older people with persistent pain: A systematic review of randomised controlled trials

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.