Is pain reporting to health care professionals age-related? A cross sectional multicenter study in a hospital setting

Abstract

Background: Failure to report pain by older patients is usually considered a major obstacle to receive adequate pain management.

Objectives: To compare the frequency of reporting pain to health care professionals (HCPs) among older (≥ 65 yrs) and younger adults (< 65 yrs) and to evaluate whether age and setting of care influence pain reporting to HCPs.

Results: Overall, 3285 patients (54.7 ≥ 65 yrs) were interviewed. Despite analgesic therapy, 2821 patients had pain. Among these, 1178 patients (41.8%) had severe pain. The frequency of patients not reporting pain to HCPs is significantly lower among older vs. younger adults (18.1 vs. 23.6%; p < 0.001). Multiple multilevel logistic regression, however, shows that nonreporting pain is not age-related, but is associated with: nonmalignant pain (OR = 1.53; 95% CI: 1.00 - 2.35; p = 0.05), a short hospitalization (OR = 1.58; 95% CI: 1.20 - 2.07; p = 0.001), admission to a hospital without a 'pain-free hospital' project (OR = 2.00; 95% CI: 1.18 - 3.39; p = 0.011).

Conclusions: The results suggest that failure to report pain does not appear to be associated with the age of the patient in itself, but with type of pain and clinical context. Both patients and physicians should be encouraged to actively address pain management. Further research is needed.