Article Figures & Data
Tables
Analgesic n (%) Any analgesic 438 (91.8) Regularly dosed analgesic 305 (63.9) As required analgesics 321 (67.3) Both as required and regularly dosed analgesics 188 (39.4) Only as required analgesics 131 (27.5) Regularly prescribed paracetamol 272 (57.0) As required paracetamol 212 (44.4) Oral non-steroidal anti-inflammatories, regularly dosed 16 (3.4) Oral non-steroidal anti-inflammatories, as required 13 (2.7) Tricyclic anti-depressant 14 (2.9) Gabapentinoids 40 (8.4) Regularly prescribed opioidsa 139 (29.1) Buprenorphine patch 73 (52.5) Extended release oxycodone/naloxone 28 (20.1) Weak opioids (tramadol; paracetamol with codeine) 17 (12.2) Immediate release oxycodone 11 (7.9) Extended release oxycodone 8 (5.8) Extended release morphine 5 (3.6) Fentanyl patch 5 (3.6) Morphine in a syringe driver 4 (2.9) Immediate release morphine liquid 2 (1.4) Hydromorphone 2 (1.4) Tapentadol 1 (0.7) As required opioidsa 169 (35.4) Immediate release oxycodone 68 (40.2) Morphine sulphate injection 38 (22.5) Paracetamol with codeine 36 (21.3) Morphine liquid 19 (11.2) Codeine phosphate 12 (7.1) Tramadol 11 (6.5) Hydrocodone 4 (2.4) Extended release oxycodone/naloxone 1 (0.6) Fentanyl injection 1 (0.6) ↵aPercentage does not equal 100% because some residents were prescribed more than one regular opioid or 'as required' opioid.
n (%) Cause of pain (n = 382) Musculoskeletal, lower extremities
Back or neck pain
Musculoskeletal, upper extremities
Generalised joint pain
Visceral pain
Neuropathic pain
Post-fracture/osteoporosis pain
Inflammatory joint conditions
Headache/migraine
Cancer-related pain191 (50.0)
134 (35.1)
112 (29.3)
32 (8.4)
17 (4.5)
15 (3.9)
13 (3.4)
13 (3.4)
11 (2.9)
3 (0.8)Treatment plan (n = 477)aa Analgesics
Heatpacks
Massage
Repositioning
Rest
Gentle exercise/physiotherapy programme
One-on-one calming
Elasticated garment
Technical equipment, for example TENS337 (70.6)
237 (49.7)
206 (43.2)
151 (31.7)
117 (24.5)
90 (18.9)
47 (9.9)
12 (2.5)
11 (2.3)↵aResidents were often documented as having a pain treatment plan even if there were no documented pain causing condition
- Table 3. Baseline demographics and patient characteristics of those with and without dementia
Residents with dementia, n (%)(n = 215) Residents without dementia, n (%)(n = 262) P value Mean age, years (IQR) 85.7 (79.7–90.6) 87.3 (80.9–91.5) 0.07 Female 80 (48.5) 177 (56.9) 0.26 Mean number of regular medicines (IQR) 7 (5–10) 9 (6–12) <0.01 ACFI pain assessment ACFI pain-causing condition 163 (75.8) 219 (83.6) 0.03 ACFI analgesics 135 (64.3) 193 (74.2) 0.02 ACFI NPT 152 (70.7) 211 (80.5) 0.01 Medication chart Any analgesia 199 (92.6) 239 (91.2) 0.60 Regularly prescribed 137 (63.7) 169 (64.5) 0.86 As required only 61 (28.4) 70 (27.7) 0.69 RD paracetamol 121 (56.3) 151 (57.6) 0.77 RD opioid 57 (26.5) 83 (31.7) 0.22 MEQ RD opioid, mg (IQR) 0 (0–6) 0 (0–10) 0.22 Pain experience ≥2 pain experiences per week 30 (14.0) 52 (19.8) 0.09 IQR = interquartile range. NPT= non-pharmacological therapy. MEQ = morphine equivalence. RD = regularly dosed.