Abstract
Introduction
Frailty and persistent pain are both common amongst OAs and together contribute to disability and emotional distress. The impact of pain on everyday life is potentially modifiable with appropriate pain management techniques, but current services do not always take account of the needs of frail OAs. The Pain in Older People with Frailty Study (POPPY) is a mixed-method study to develop the content and implementation strategies for services to optimise the support available for OAs living with frailty and pain. Initial objectives of the POPPY study included seeking views from healthcare professionals (HCPs) and commissioners on existing local services including their experiences of the barriers faced by OAs with frailty accessing these services, and views on how resources might be best deployed to support OAs with frailty.
Methods
In-depth qualitative interviews were conducted with HCPs from across England, based in specialist, secondary care and community services. Interviewees included commissioners, GPs, physiotherapists, occupational therapists, psychologists, nurses, doctors, and health coaches. A thematic approach to data analysis was used.
Results
Forty-two HCPs and 2 commissioners from 9 pain services and 2 generic community services were interviewed. HCPs recognised that OAs living with frailty and pain formed a distinct group, experiencing shared facilitators and barriers to engagement. Meeting the needs of this group was challenging for services. Most HCPs thought a dedicated pain service for frail OAs was impractical and disagreed with the concept of age-based pain services. HCPs thought the needs of frail OAs were most likely to be met by community-based services, staffed with appropriately skilled multi-disciplinary teams, interacting effectively with other specialist services, and delivering holistic individualised approaches.
Conclusion
Pain services need to be responsive to the specific needs of OAs with frailty and recognise the importance of adapting content and delivery of interventions to reflect this.