Hospice enrollment and pain assessment and management in nursing homes

Susan C. Miller; Vincent Mor; Joan Teno

doi:10.1016/S0885-3924(03)00284-7

Hospice enrollment and pain assessment and management in nursing homes

Susan C. Miller
, Vincent Mor
, Joan Teno

Research output: Contribution to journal › Article › peer-review

149 Scopus citations

Abstract

This study compared pain assessment and management in the last 48 hours of life for hospice and nonhospice nursing home residents. Included were 209 hospice and 172 nonhospice residents in 28 nursing homes in six geographic areas. Hospice patients were considered short-stay (seven days or less) (n = 51), or longer-stay (over seven days) (n = 158). Of residents not in a hospital or a coma (n = 265), 33% of nonhospice residents, 6% of short-stay and 7% of longer-stay hospice residents had no documented pain assessment (P<0.05). For those with pain documented (n = 93), longer-stay hospice residents, compared to nonhospice residents, had a significantly greater likelihood of having received an opioid (adjusted odds ratio [AOR] 5.4; 95% CI 1.3, 21.7), and an opioid at least twice a day (AOR 2.7; 95% CI 0.9, 7.7; P = 0.07). Study results suggest that hospice enrollment improves pain assessment and management for nursing home residents; they also document the need for continued improvement of pain management in nursing homes.

Original language	English (US)
Pages (from-to)	791-799
Number of pages	9
Journal	Journal of Pain and Symptom Management
Volume	26
Issue number	3
DOIs	https://doi.org/10.1016/S0885-3924(03)00284-7
State	Published - Sep 1 2003
Externally published	Yes

Funding

We wish to thank the hospice and nursing home providers who participated in this research. We also wish to thank the senior research assistants Joyce Babcock, MS, Jill Hauben, BS, and Jayne Macedo, AS who coordinated study functions. Thanks also to data abstractors Sharon Bayha, RN, Nina Sutherland, RN and Nancy Wolf-Jensen, MSW. This study was funded by grant number 97-385 from the Retirement Research Foundation.

Funders
Retirement Research Foundation

Keywords

End-of-life
Hospice
Nursing home
Pain assessment
Pain management

ASJC Scopus subject areas

General Nursing
Clinical Neurology
Anesthesiology and Pain Medicine

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10.1016/S0885-3924(03)00284-7

Cite this

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abstract = "This study compared pain assessment and management in the last 48 hours of life for hospice and nonhospice nursing home residents. Included were 209 hospice and 172 nonhospice residents in 28 nursing homes in six geographic areas. Hospice patients were considered short-stay (seven days or less) (n = 51), or longer-stay (over seven days) (n = 158). Of residents not in a hospital or a coma (n = 265), 33\% of nonhospice residents, 6\% of short-stay and 7\% of longer-stay hospice residents had no documented pain assessment (P<0.05). For those with pain documented (n = 93), longer-stay hospice residents, compared to nonhospice residents, had a significantly greater likelihood of having received an opioid (adjusted odds ratio [AOR] 5.4; 95\% CI 1.3, 21.7), and an opioid at least twice a day (AOR 2.7; 95\% CI 0.9, 7.7; P = 0.07). Study results suggest that hospice enrollment improves pain assessment and management for nursing home residents; they also document the need for continued improvement of pain management in nursing homes.",

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N2 - This study compared pain assessment and management in the last 48 hours of life for hospice and nonhospice nursing home residents. Included were 209 hospice and 172 nonhospice residents in 28 nursing homes in six geographic areas. Hospice patients were considered short-stay (seven days or less) (n = 51), or longer-stay (over seven days) (n = 158). Of residents not in a hospital or a coma (n = 265), 33% of nonhospice residents, 6% of short-stay and 7% of longer-stay hospice residents had no documented pain assessment (P<0.05). For those with pain documented (n = 93), longer-stay hospice residents, compared to nonhospice residents, had a significantly greater likelihood of having received an opioid (adjusted odds ratio [AOR] 5.4; 95% CI 1.3, 21.7), and an opioid at least twice a day (AOR 2.7; 95% CI 0.9, 7.7; P = 0.07). Study results suggest that hospice enrollment improves pain assessment and management for nursing home residents; they also document the need for continued improvement of pain management in nursing homes.

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Hospice enrollment and pain assessment and management in nursing homes

Abstract

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Keywords

ASJC Scopus subject areas

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