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

Background: The management of pain by GPs for residents of aged care facilities (ACFs) is verycommon.Aim: To measure the prevalence and assess the management of pain in ACF residents, particularlythose with dementia.Design & setting: A retrospective review of ACF residents’ medical records was undertaken at fivesouthern Tasmanian (Australia) ACFs.Method: Data extracted included results of the most recent assessment of pain and itsmanagement, frequency and treatment of pain incidents in the previous 7 days, demographics, andmedical and medication history. Univariate analysis was used to identify variables associated withincreased frequency of pain episodes.Results: The final analysis included 477 residents. At least one episode of pain in the preceding 7days was documented in 25.6% (n = 122) of residents’ notes. Pain episodes were most commonlymanaged by analgesics (45.5%), massage (40.7%), and heatpacks (13.8%). Residents with dementiawere not less likely to have pain identified during the past week (14% versus 20%; P = 0.09), butthey were much less likely to have pain identified on their most recent pain assessment (P = 0.03).Conclusion: 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 allpain 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 thepossibility of the resident experiencing pain