Many nursing home residents have poorly controlled pain due to inadequate medication treatment

Mar 1 2006

Researchers have discovered that many nursing home residents have poorly controlled pain due to inadequate medication treatment. The results of the study are published in the Journal of the American Geriatrics Society.

An interdisciplinary team of researchers designed and tested a Nursing Home Pain Medication Appropriateness Scale (PMAS) to screen the overall suitability of prescribing practices for pain in a nursing home setting. They compared the direct resident pain assessments conducted by trained research assistants to the pain medications prescribed.

Data revealed the mean total PMAS was 64 percent of optimal, suggesting a generally poor score. In fact, they found that less than half of residents with predictably recurrent pain were being prescribed scheduled pain medication; 23 percent received at least one high-risk medication. PMAS scores were better for residents who were not in pain and in homes where the nurses’ knowledge improved or stayed the same during an intervention designed to improve nursing homes’ pain management practices.

“The inclusion of pain as a quality measure for both short-term and long-term residents is intended to provide an incentive for nursing homes to improve their practices in this area,” say researchers. “The use of evidence-based process measures will permit an organization to begin addressing persistent problems in pain management.”

According to the American Geriatrics Society Panel on Persistent Pain in Older Persons, 45 to 80 percent of nursing home residents have substantial pain. The consequences of poor pain management include sleep deprivation, poor nutrition, depression, anxiety, agitation, decreased activity, delayed healing and lower overall quality of life.

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