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Many Nursing Home Residents Fail to Receive Adequate Pain Control Due to Deficiencies in Medication Prescribing Practices – Study

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A new study conducted by an interdisciplinary team of researchers, and published in the Journal of the American Geriatrics Society, has found that the medication prescribing practices in place at many nursing homes results in poor pain management in residents.

As reported in Medical News Today (3/4/06), the 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.”

The team then compared pain assessments performed by trained assistants to the actual medications being prescribed to the residents being evaluated.

The results of the analysis were disappointing in that the “mean” total PMAS was only 64% of optimal and less than 50% of the residents who had “predictably recurrent pain” were actually receiving pain medication. Prescribing of pain medication on the PMAS was found to be better in situations where residents were not in recurrent pain.

Pain is a significant problem in older people and nursing home residents are certainly no exception. The American Geriatrics Society estimates that between 45% and 80% of nursing home residents experience significant pain (Panel on Persistent Pain in Older Persons).

Living in pain, as a result of inadequate pain management, tends to lower a persons overall quality of life and leads to other consequences such as sleep deprivation, poor nutrition, depression, anxiety, agitation, decreased activity, and delayed healing.

According to the researchers: “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. The use of evidence-based process measures will permit an organization to begin addressing persistent problems in pain management.”

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