Psychosocial Interventions for Chronic Non-Cancer Pain Among Older Adults: A Scoping Review.

BackgroundChronic non-cancer pain (CNCP) disproportionately affects older adults, yet randomized trial evidence on psychosocial interventions in this population remains poorly characterized.ObjectiveTo map the randomized controlled trial (RCT) literature evaluating psychosocial interventions for CNCP in older adults.MethodsFollowing Arksey and O'Malley, we searched four databases (1999-August 2024). Eligible studies were RCTs enrolling adults with mean age ≥60 years with CNCP, evaluating structured psychosocial interventions; headache and cancer pain were excluded. Two reviewers screened records. Of 7,394 studies, 49 met inclusion criteria.ResultsTrials mainly evaluated cognitive-behavioral therapy, self-management, acceptance and commitment therapy, and emotional awareness and expression therapy. Among trials specifying primary outcomes, pain intensity and physical function predominated. Psychosocial constructs were rarely primary endpoints. Adherence, fidelity, and adverse event reporting varied considerably.ConclusionsOutcome prioritization is misaligned with the mechanisms of psychosocial interventions. Future RCTs should pre-register psychosocial outcome measures, standardize reporting, and recruit diverse samples.