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The assessment of pain in older people: UK national guidelines
- Author:
- SCHOFIELD Pat
- Journal article citation:
- Age and Ageing, 47(suppl 1), 2018, p.i1–i22.
- Publisher:
- Oxford University Press
This guidance highlights the problems in assessing and managing pain in an ever increasing older population. This brings an anticipated increase in the prevalence of chronic pain and with this comes the challenge of assessment of pain in many varied settings. The first iteration of this guideline was published in 2007. But there has been a proliferation of literature and research since then, so this is a a revised set of guidelines based on a systematic review to examine the evidence for the effectiveness of pain assessment strategies in older people with or without cognitive function. The objectives of the review included: exploring the attitudes and beliefs of older people with pain about the assessment of their pain and interactions with carers; evaluating the effectiveness of the assessment of function as a measure of pain in older people; evaluating the effectiveness of self-assessment to quantify pain in older people and determining if changes in pain assessment strategy are required for people with cognitive impairment, mental health or psychological problems. These guidelines provide a range of tools which demonstrate good validity and reliability for clinical practice in assessing pain in older people. (Original abstract)
Arthritis pain
- Authors:
- YOON Eunkyung, DOHERTY John B.
- Journal article citation:
- Journal of Gerontological Social Work, 50(S1), 2008, pp.79-103.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Arthritic pain is a common and disabling condition for many older people in the USA, and is often under-treated despite its significant negative impact on quality of life. This systematic review examines the empirical literature on psychosocial interventions, including cognitive-behavioural treatments and psycho-educational interventions. The former has been shown to have a major positive impact on pain control, while the latter has contributed to better understanding and self-treatment. The paper concludes with a ‘treatment resource appendix’ directed at US practitioners. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
A systematic review of the scientific evidence for the efficacy of a palliative care approach in advanced dementia
- Author:
- SAMPSON E L
- Journal article citation:
- International Psychogeriatrics, 17(1), March 2005, pp.31-40.
- Publisher:
- Cambridge Journals
There is a call for an improvement in the end-of-life care for patients with dementia. A systematic review of the literature identified only two clinical trials or guidelines examining the influence of palliative care on patients with this condition. The authors discuss the ethical difficulties surrounding such research, prognostic uncertainty and the lack of clear outcome measures for patients unable to express their needs or wishes.
Pain treatment of agitation in patients with dementia: a systematic review
- Authors:
- HUSEBO B.S., BALLARD C., AARSLAND D.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 26(10), October 2011, pp.1012-1018.
- Publisher:
- Wiley
Dementia is frequently accompanied by behavioural and psychological symptoms (BPSD), including agitation and aggression, particularly in nursing home patients. Advancing age is associated with a high prevalence of pain. It has been suggested that unrecognised and untreated pain may contribute to BPSD in people with dementia. The objective of this paper is to systematically review the evidence that pain medication can improve agitation in people with dementia. A systematic search of the PubMed and Cochrane databases for the period 1992–2010 was performed. The search aimed to identify controlled studies of interventions focusing on pain reduction for patients with dementia with outcome measures including agitation or other related behavioural disturbances. Only 3 trials were identified; all were cross-over trials, and 2 included small sample sizes of less than 50 participants. The findings were inconsistent, and although some correlations were reported, these did not support the hypothesis that pain management reduces agitation. The article concludes that there is a lack of rigorous studies of the effect of pain treatment in patients with dementia and agitation.
Management of depression in older people with osteoarthritis: a systematic review
- Authors:
- YOHANNES Abebaw Mengistu, CATON Sue
- Journal article citation:
- Aging and Mental Health, 14(6), August 2010, pp.637-651.
- Publisher:
- Taylor and Francis
Osteoarthritis is the most common form of arthritis, and depressive symptoms are common in older people with arthritic pain. The aim of this review was to evaluate data from clinical trials testing the effectiveness of various interventions for older patients suffering from osteoarthritis and depression. Literature searches resulted in the identification of 14 studies which fulfilled the inclusion criteria for the review. Interventions highlighted in these studies were: patient education programmes, cognitive behavioural therapy, depression care and pharmacological intervention, and exercise therapy. Eleven of the 14 interventions showed some improvement in patients' depressive symptoms in the short term. The authors concluded that there was some evidence to suggest that the intervention of cognitive behavioural therapy, integrated depression care management and exercise therapy were associated with reduced depressive symptoms in the short term, but that the long-term benefits of depression management in patients with osteoarthritis and depression are unknown and that further controlled clinical trials are needed.