Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Apr-Jun;5(2):126-31.
doi: 10.4103/2279-042X.179578.

Pain monitoring and medication assessment in elderly nursing home residents with dementia

Mette Marie Tang  1 , Morten Gill Wollsen  2 , Lise Aagaard  1
Affiliations

Pain monitoring and medication assessment in elderly nursing home residents with dementia

Mette Marie Tang et al. J Res Pharm Pract. 2016 Apr-Jun.

Abstract

Objective: To monitor pain intensity, pain symptoms, and medication use in elderly with dementia.

Methods: Nursing home residents above 65 years of age, diagnosed with dementia, and showing pain symptoms were included in the study. The patients' mental status was monitored through a mini-mental state examination score and observations of pain symptoms using Part 1 of the Mobilization-Observation-Behaviour-Intensity-Dementia-2 (MOBID-2) pain scale. Community pharmacists reviewed the patients' medication use, and the prescriptions were compared with guidelines for treatment of geriatric patients. Alterations to the patients' medicine use were forwarded to the general practitioners.

Findings: Sixty-one nursing home residents diagnosed with dementia were identified, 15 of these fulfilled the inclusion criteria, and 12 agreed to participate in the study. The mean age was 87 years of age (range: 77-96), and 42% of the residents were males. The patients' overall pain intensity was 83% for observations on the numeric pain rating scale (NRS) >0 and 67% for NRS ≥3. Most painful were the situations in which the residents were to mobilize their legs, turn around to both sides of the bed, and when sitting on the bed. The medication reviews identified a total of 95 individual prescriptions, and 33% of these were for nervous system medications, followed by medicines for the treatment of alimentary tract and metabolism disorders (31% of total). Eleven prescriptions for pain medicine were identified; the majority of these were for paracetamol and opioids. Seventeen proposals to patients' medication use were suggested, but the general practitioners accepted only 6% of these.

Conclusion: This study indicates that the MOBID-2 pain scale in combination with medication reviews can be used as a tool for optimization of patients' medication use. However, we recommend the conduction of a larger-scale study in multiple settings, to validate our results and the generalizability of the findings.

Keywords: Dementia; Denmark; elderly; medication review; nursing home residents; pain assessment; pain intensity; pain symptoms.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Achterberg WP, Pieper MJ, van Dalen-Kok AH, de Waal MW, Husebo BS, Lautenbacher S, et al. Pain management in patients with dementia. Clin Interv Aging. 2013;8:1471–82. - PMC - PubMed
    1. Hadjistavropoulos T, Herr K, Prkachin KM, Craig KD, Gibson SJ, Lukas A, et al. Pain assessment in elderly adults with dementia. Lancet Neurol. 2014;13:1216–27. - PubMed
    1. Reynolds KS, Hanson LC, DeVellis RF, Henderson M, Steinhauser KE. Disparities in pain management between cognitively intact and cognitively impaired nursing home residents. J Pain Symptom Manage. 2008;35:388–96. - PubMed
    1. Weiner D, Peterson B, Keefe F. Chronic pain-associated behaviors in the nursing home: Resident versus caregiver perceptions. Pain. 1999;80:577–88. - PubMed
    1. Nygaard HA, Jarland M. Are nursing home patients with dementia diagnosis at increased risk for inadequate pain treatment? Int J Geriatr Psychiatry. 2005;20:730–7. - PubMed