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Pain Management in Nursing Home Residents: Results from the Incur Study

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The journal of nutrition, health & aging

Abstract

Objectives

Pain is very common among older persons living in nursing home, affecting 45% to 80% of residents, interfering with daily activities and quality of life. Aims of the study are: 1) to measure the analgesics non-prescription in nursing home residents who present pain symptoms; 2) to identify the main determinants of analgesics non-prescription.

Design

Retrospective cross-sectional analysis.

Setting

Data from an observational study (‘Incidence of pNeumonia and related ConseqUences in nursing home Residents’ [INCUR] study).

Participants

800 older persons living in 13 French nursing homes.

Measurments

Pain symptoms were definied by one of the following criteria: i) Presence of pain affecting the individual’s function in the Activities of Daily Living; ii) Presence of daily pain, and/or; iii) Severe pain measured with a visual analogue scale.

Results

Among the patients originally included in the study, 288 (36%) reported pain symptomatology (mean age 86.9 [SD 7.2] years, 220 (76%) participants women). Amongst these, 138 (47.9%) were treated with non-opioid analgesic drugs, 52 (18.1%) with opioids, and 98 (34%) did not receive any analgesic prescription. An adjusted logistic regression analysis found that the strongest determinant of analgesics non-prescription was the number of concomitantly prescribed drugs (p<0.001). Age, education, and frailty were not associated with prescription of analgesic drugs.

Conclusions

Pain undertreatment is very common among older persons living in nursing homes. The number of prescribed medications represents the most relevant risk factor for the analgesics non-prescription. Our findings document the importance of reviewing prescriptions in nursing home residents.

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Acknowledgments

We thank Drs. Luca Mollo and Sedipeh Attal at Pfizer for their help and assistance. We also thank all the people who is making the INCUR project possible, in particular the clinical and administrative personnel of the participating nursing homes: Centre Hospitalier de Castelnaudary, De Vinci, Faux-Bourg Saint Adrien, Jean Loubès, Le Pastel, Domaine de Lasplanes, La Triade, Le Castelou, Le Garnagues, Maréchal Leclerc, Montréal, Saint Jacques, Saint Joseph.

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Authors and Affiliations

  1. Geriatric Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Pace 9, 20122, Milan, Italy

    V. Nunziata, Marco Proietti, E. Saporiti, L. Calcaterra & M. Cesari

  2. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

    Marco Proietti & M. Cesari

  3. Liverpool Centre for Cardiovascular Science, University of Liverpool, and Liverpool Heart & Chest Hospital, Liverpool, UK

    Marco Proietti

  4. Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France

    Y. Rolland & B. Vellas

  5. UMR INSERM, Toulouse, France

    B. Vellas

Authors
  1. V. Nunziata
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  2. Marco Proietti
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  3. E. Saporiti
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  4. L. Calcaterra
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  5. Y. Rolland
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  6. B. Vellas
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  7. M. Cesari
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Corresponding author

Correspondence to Marco Proietti.

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Conflict of interest

None of the authors have any interest to disclose.

Funding sources

he INCUR study was originally funded by Pfizer. The funding agency had no role in the design and conduction of the study. No funding was used to prepare the current manuscript.

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Nunziata, V., Proietti, M., Saporiti, E. et al. Pain Management in Nursing Home Residents: Results from the Incur Study. J Nutr Health Aging 24, 1019–1022 (2020). https://doi.org/10.1007/s12603-020-1513-2

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  • DOI: https://doi.org/10.1007/s12603-020-1513-2

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