A retrospective review of pain management in Tasmanian residential aged care facilities.

Abstract

The management of pain by GPs for residents of aged care facilities (ACFs) is very common. To measure the prevalence and assess the management of pain in ACF residents, particularly those with dementia. A retrospective review of ACF residents' medical records was undertaken at five southern Tasmanian (Australia) ACFs. Data extracted included results of the most recent assessment of pain and its management, frequency and treatment of pain incidents in the previous 7 days, demographics, and medical and medication history. Univariate analysis was used to identify variables associated with increased frequency of pain episodes. The final analysis included 477 residents. At least one episode of pain in the preceding 7 days was documented in 25.6% (<i>n</i> = 122) of residents' notes. Pain episodes were most commonly managed by analgesics (45.5%), massage (40.7%), and heatpacks (13.8%). Residents with dementia were not less likely to have pain identified during the past week (14% versus 20%; <i>P</i> = 0.09), but they were much less likely to have pain identified on their most recent pain assessment (<i>P</i> = 0.03). GPs should carefully consider the suitability of using 'as required' analgesics. Furthermore, on admission to an ACF, GPs need to ensure a patient's medical history includes all pain or potentially pain-causing conditions, to ensure that a resident's pain assessment is complete. This is especially necessary for those with dementia, to ensure that staff remain vigilant about the possibility of the resident experiencing pain.