Study: Educational, Organizational Interventions Can Improve Pain Management
Identifying, assessing, and managing pain in residents has long been a top priority for nursing home (NH) practitioners and interdisciplinary teams. A new study in the December issue of JAMDA suggests that combining educational and organizational measures, as well as evaluating pain as a patient-reported outcome, can help decrease pain complaints and improve pain management.
The study, “Effect of an Educational and Organizational Intervention on Pain in Nursing Home Residents: A Nonrandomized Controlled Trial,” involved over 3,500 residents in 159 NHs in France. Facilities were allocated either to a strong intervention group or to a light intervention group. The strong intervention group involved cooperative work between a hospital geriatrician and NH staff around quality indicators of care. Residents allocated to this group were significantly older, more depressed, mostly female, in greater pain, and/or end-of-life residents, compared to the individuals in the light intervention group.
At baseline, 437 residents in the light intervention group and 424 residents in the strong intervention group complained about pain. After 18 months, 471 in the light intervention group and 379 in the strong intervention group reported such problems. The authors said, “Our results support [the idea] that a general geriatric intervention based on education and professional support to NH staff not only improved quality of pain management but was also associated with a lower number of residents who complain about pain.”
While it is essential to educate and engage NH teams regarding pain management, the authors noted, “External teams can efficiently support NH staff in difficult pain diagnoses and management.” This support, they said, can come from geriatricians, hospice professionals, and others and may help improve the use of analgesics, specifically opioids. They further observed that telemedicine could be an option to broaden and maximize pain management efforts.
This study was conducted by researchers at the Gerontopole of Toulouse, Institute on Aging, Toulouse University Hospital, in France.
JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine. JAMDA publishes peer-reviewed articles including original studies, reviews, clinical experience articles, case reports, and more, on all topics more important to post-acute and long-term care medicine. Visit www.jamda.com for more information.
About the Society for Post-Acute and Long-Term Care Medicine
AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PA/LTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit www.paltc.org for more information.