The Quality of Pain Treatment in Community-Dwelling Persons with Dementia

被引：5
作者：
Li, Jiwen [4 ]
Snow, A. Lynn [1 ,2 ]
Wilson, Nancy [3 ,4 ]
Stanley, Melinda A. [3 ,4 ,6 ]
Morgan, Robert O. [5 ]
Sansgiry, Shubhada [3 ,4 ,6 ]
Kunik, Mark E. [3 ,4 ,6 ]
机构：
[1] Univ Alabama, Tuscaloosa, AL USA
[2] Tuscaloosa VA Med Ctr, Tuscaloosa, AL USA
[3] Houston VA HSR&D Ctr Innovat Qual Effectiveness &, Houston, TX USA
[4] Baylor Coll Med, Houston, TX 77030 USA
[5] Univ Texas Sch Publ Hlth Houston, Houston, TX USA
[6] VA South Cent Mental Illness Res Educ & Clin Ctr, Houston, TX USA
来源：
DEMENTIA AND GERIATRIC COGNITIVE DISORDERS EXTRA | 2015年 / 5卷 / 03期
关键词：
Dementia; Pain management; Quality indicators; health care; Veterans;
D O I：
10.1159/000441717
中图分类号：
R74 [神经病学与精神病学];
学科分类号：
摘要：
Background/Aims: Despite pervasive and debilitating pain among elders, it is underassessed and undertreated; and cognitive impairment can add challenges. We assessed the quality of pain care for community-dwelling elderly patients with dementia. Methods: We phone interviewed 203 Veterans Affairs primary care outpatients with dementia and pain and reviewed medical records to score 15 quality indicators of pain assessment and management. Results: Pain assessment was documented for 98%, and a standard pain scale was used for 94%. Modified pain scales were rarely used. Though 70% self-reported pain of ` quite bad' or worse, charts documented no pain in 64%. When pain was identified, treatment was offered to 80%; but only 59% had a follow-up assessment within 6 months. Nonpharmacological interventions were underused. Conclusion: Community-dwelling elders with dementia are underdiagnosed and undertreated for pain. (C) 2015 The Author(s) Published by S. Karger AG, Basel
引用
收藏
页码：470 / 481
页数：12
相关论文
共 56 条
  • [11] Closs SJ, 2004, BRIT J GEN PRACT, V54, P919
  • [12] Cancer pain management and the JCAHO's pain standards: An institutional challenge
    Cohen, MZ
    Easley, MK
    Ellis, C
    Hughes, B
    Ownby, K
    Rude, M
    Taft, E
    Westbrooks, JB
    [J]. JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 2003, 25 (06) : 519 - 527
  • [13] Cohen-Mansfield Jiska, 2002, Am J Alzheimers Dis Other Demen, V17, P249, DOI 10.1177/153331750201700404
  • [14] A randomized trial of risperidone, placebo, and haloperidol for behavioral symptoms of dementia
    De Deyn, PP
    Rabheru, K
    Rasmussen, A
    Bocksberger, JP
    Dautzenberg, PLJ
    Eriksson, S
    Lawlor, BA
    [J]. NEUROLOGY, 1999, 53 (05) : 946 - 955
  • [15] Dziechciaz M, 2013, ANN AGR ENV MED, P35
  • [16] Quality indicators for pain management in vulnerable elders
    Etzioni, Shiri
    Chodosh, Joshua
    Ferrell, Bruce A.
    MacLean, Catherine H.
    [J]. JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2007, 55 : S403 - S408
  • [17] The management of persistent pain in older persons
    Ferrell, B
    Casarett, D
    Epplin, J
    Fine, P
    Gloth, FM
    Herr, K
    Katz, P
    Keefe, F
    Koo, PJS
    O'Grady, M
    Szwabo, P
    Vallerand, AH
    Weiner, D
    [J]. JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2002, 50 : S205 - S224
  • [18] Quality of osteoarthritis care for community-dwelling older adults
    Ganz, DA
    Chang, JT
    Roth, CP
    Guan, N
    Kamberg, CJ
    Niu, F
    Reuben, DB
    Shekelle, PG
    Wenger, NS
    Maclean, CH
    [J]. ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH, 2006, 55 (02): : 241 - 247
  • [19] Measuring movement-exacerbated pain in cognitively impaired frail elders
    Hadjistavropoulos, T
    LaChapelle, DL
    MacLeod, FK
    Snider, B
    Craig, KD
    [J]. CLINICAL JOURNAL OF PAIN, 2000, 16 (01) : 54 - 63
  • [20] Tools for assessment of pain in nonverbal older adults with dementia: A state-of-the-science review
    Herr, K
    Bjoro, K
    Decker, S
    [J]. JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 2006, 31 (02) : 170 - 192
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