Key points are not available for this paper at this time.
Abstract Background Current knowledge about the quality and appropriateness of pharmacological pain treatment in nursing home residents ( NHR ), particularly in NHR with moderate to severe cognitive impairment, is poor. Methods This observational cross‐sectional study assessed pain treatment in a random sample of NHR with or without cognitive impairment from nursing homes in G ermany. Prescribed drugs, pain intensity and frequency, diagnoses, and surgical procedures and injuries during the last 4 weeks were documented. Quality and appropriateness of pain medication were assessed by analysis of pain medications and the P ain M edication A ppropriateness S cale ( PMAS ) score ( S PMAS ), with a cut‐off value of >67% indicating appropriate pain treatment. Results A total of 321 residents (62% women) were studied, including 152 (47%) with severe cognitive impairment. The most frequently prescribed analgesics were dipyrone, fentanyl, tramadol and ibuprofen. The mean S PMAS was 48.5 ± 1.5 (range, −33 to +100). Residents with prescribed scheduled analgesics had a significantly better S PMAS than patients without such treatment ( S PMAS 58 ± 1.5 vs. 37 ± 2.5, p < 0.01). NHR without current pain had significantly better S PMAS than residents suffering from pain ( S PMAS 47 ± 1.9 vs. 59 ± 4.2, p = 0.01). With an S PMAS of 69 ± 1.5, residents ( n = 106) with scheduled pain medication plus PRN analgesics achieved the highest scores in the population. Overall, similar results were found in NHR with and in NHR without cognitive impairment. Conclusion Our study points to a significant deficit in pain treatment in German NHR , including NHR with or without cognitive impairment.
Kölzsch et al. (Mon,) studied this question.