Felicity Veal1, Mackenzie Williams1, Luke Bereznicki2, Elizabeth Cummings3, Tania Winzenberg4. 1. Lecturer in Pharmacy Practice, Unit for Medication Outcomes Research & Education (UMORE), Pharmacy, School of Medicine, University of Tasmania, Hobart, Australia. 2. Professor in Pharmacy Practice, Unit for Medication Outcomes Research & Education (UMORE), Pharmacy, School of Medicine, University of Tasmania, Hobart, Australia. 3. Senior Lecturer, Nursing and Midwifery, School of Health Sciences, Hobart, University of Tasmania, Hobart, Australia. 4. Professor in Chronic Disease Management, Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
Abstract
BACKGROUND: The management of pain by GPs for residents of aged care facilities (ACFs) is very common. AIM: To measure the prevalence and assess the management of pain in ACF residents, particularly those with dementia. DESIGN & SETTING: A retrospective review of ACF residents' medical records was undertaken at five southern Tasmanian (Australia) ACFs. METHOD: Data extracted included results of the most recent assessment of pain and its management, frequency and treatment of pain incidents in the previous 7 days, demographics, and medical and medication history. Univariate analysis was used to identify variables associated with increased frequency of pain episodes. RESULTS: The final analysis included 477 residents. At least one episode of pain in the preceding 7 days was documented in 25.6% (n = 122) of residents' notes. Pain episodes were most commonly managed by analgesics (45.5%), massage (40.7%), and heatpacks (13.8%). Residents with dementia were not less likely to have pain identified during the past week (14% versus 20%; P = 0.09), but they were much less likely to have pain identified on their most recent pain assessment (P = 0.03). CONCLUSION: GPs should carefully consider the suitability of using 'as required' analgesics. Furthermore, on admission to an ACF, GPs need to ensure a patient's medical history includes all pain or potentially pain-causing conditions, to ensure that a resident's pain assessment is complete. This is especially necessary for those with dementia, to ensure that staff remain vigilant about the possibility of the resident experiencing pain.
BACKGROUND: The management of pain by GPs for residents of aged care facilities (ACFs) is very common. AIM: To measure the prevalence and assess the management of pain in ACF residents, particularly those with dementia. DESIGN & SETTING: A retrospective review of ACF residents' medical records was undertaken at five southern Tasmanian (Australia) ACFs. METHOD: Data extracted included results of the most recent assessment of pain and its management, frequency and treatment of pain incidents in the previous 7 days, demographics, and medical and medication history. Univariate analysis was used to identify variables associated with increased frequency of pain episodes. RESULTS: The final analysis included 477 residents. At least one episode of pain in the preceding 7 days was documented in 25.6% (n = 122) of residents' notes. Pain episodes were most commonly managed by analgesics (45.5%), massage (40.7%), and heatpacks (13.8%). Residents with dementia were not less likely to have pain identified during the past week (14% versus 20%; P = 0.09), but they were much less likely to have pain identified on their most recent pain assessment (P = 0.03). CONCLUSION: GPs should carefully consider the suitability of using 'as required' analgesics. Furthermore, on admission to an ACF, GPs need to ensure a patient's medical history includes all pain or potentially pain-causing conditions, to ensure that a resident's pain assessment is complete. This is especially necessary for those with dementia, to ensure that staff remain vigilant about the possibility of the resident experiencing pain.
Entities:
Keywords:
Care of the elderly; Pain; Patient groups; Prescribing; general practice; primary healthcare
Authors: Katherine R Jones; Regina M Fink; Lauren Clark; Evelyn Hutt; Carol P Vojir; B Karen Mellis Journal: J Am Med Dir Assoc Date: 2005 Jan-Feb Impact factor: 4.669
Authors: Joseph Pergolizzi; Rainer H Böger; Keith Budd; Albert Dahan; Serdar Erdine; Guy Hans; Hans-Georg Kress; Richard Langford; Rudolf Likar; Robert B Raffa; Paola Sacerdote Journal: Pain Pract Date: 2008-05-23 Impact factor: 3.183