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Article
Pain management in nursing home residents with cancer
Quantitative Health Sciences Publications and Presentations
  • Camilla B. Pimentel, University of Massachusetts Medical School
  • Becky A. Briesacher, Northeastern University
  • Jerry H. Gurwitz, University of Massachusetts Medical School
  • Allison B. Rosen, University of Massachusetts Medical School
  • Marc T. Pimentel, Brigham and Women's Hospital
  • Kate L. Lapane, University of Massachusetts Medical School
UMMS Affiliation
Clinical and Population Health Research Program, Graduate School of Biomedical Sciences; Meyers Primary Care Institute; Department of Quantitative Health Sciences
Date
4-1-2015
Document Type
Article
Abstract
OBJECTIVES: To assess improvements in pain management of nursing home (NH) residents with cancer since the implementation of pain management quality indicators. DESIGN: Cross-sectional. SETTING: One thousand three hundred eighty-two U.S. NHs (N = 1,382). PARTICIPANTS: Newly admitted, Medicare-eligible NH residents with cancer (N = 8,094). MEASUREMENTS: Nationwide data on NH resident health from Minimum Data Set 2.0 linked to all-payer pharmacy dispensing records (February 2006-June 2007) were used to determine prevalence of pain, including frequency and intensity, and receipt of nonopioid and opioid analgesics. Multinomial logistic regression was used to evaluate resident-level correlates of pain and binomial logistic regression to identify correlates of untreated pain. RESULTS: More than 65% of NH residents with cancer had any pain (28.3% daily, 37.3% < daily), 13.5% of whom had severe and 61.3% had moderate pain. Women; residents admitted from acute care or who were bedfast; and those with compromised activities of daily living, depressed mood, an indwelling catheter, or a terminal prognosis were more likely to have pain. More than 17% of residents in daily pain (95% confidence interval (CI) = 16.0-19.1%) received no analgesics, including 11.7% with daily severe pain (95% CI = 8.9-14.5%) and 16.9% with daily moderate pain (95% CI = 15.1-18.8%). Treatment was negatively associated with age of 85 and older (adjusted OR (aOR) = 0.67, 95% CI = 0.55-0.81 vs aged 65-74), cognitive impairment (aOR = 0.71, 95% CI = 0.61-0.82), presence of feeding tube (aOR = 0.77, 95% CI = 0.60-0.99), and restraints (aOR = 0.50, 95% CI = 0.31-0.82). CONCLUSION: Untreated pain is still common in NH residents with cancer and persists despite pain management quality indicators. Geriatrics Society.
Rights and Permissions
Citation: J Am Geriatr Soc. 2015 Apr;63(4):633-41. doi: 10.1111/jgs.13345. Link to article on publisher's site
Comments

First author Camilla Pimental is a doctoral student in the Clinical and Population Health Research Program in the Graduate School of Biomedical Sciences (GSBS) at UMass Medical School.

Related Resources
Link to Article in PubMed
Keywords
  • analgesics,
  • cancer,
  • nursing home,
  • pain
Citation Information
Camilla B. Pimentel, Becky A. Briesacher, Jerry H. Gurwitz, Allison B. Rosen, et al.. "Pain management in nursing home residents with cancer" Vol. 63 Iss. 4 (2015) ISSN: 0002-8614 (Linking)
Available at: http://works.bepress.com/allison_rosen/55/