Advancing the pain management in older adults agenda forward through the development of key research and education priorities: A Canadian perspective

Abstract

Background: The undermanagement of pain in older adults has been identified as a problem worldwide. Aims: The purpose of this research is to identify priority areas in education and research for future development with the aim of improving pain management in older persons. In addition, barriers to addressing these priorities are identified. Methods: This mixed methods study, based on a modified Delphi approach, included three distinct components: (1) a qualitative component using focus groups with key informants or experts in the field of pain management in older adults (n = 17), (2) a scoping review of the literature, and (3) a survey of ranked responses completed by the same key informants who attended the focus groups. Thematic analysis was used to identify the initial list of issues and descriptive statistics were used for ranking them. Results: A number of concerns related to both education and research were frequently endorsed by participants. For education, they identified the need for more content in both undergraduate and continuing education programs related to documenting about pain; assessing pain, and learning about the complexities of pain. Research priorities included the need to explore successful practice models; costs of untreated pain; effects of mobility on pain; and patient preferences for pain management. Key barriers to addressing these barriers included lack of staff time and resources and unfamiliarity with pain assessment tools. Conclusion: These findings highlight priority issues related to pain management in older adults from a nationwide perspective. RÉSUMÉ Contexte : La prise en charge insuffisante de la douleur chez les adultes plus âgés est considérée comme un problème partout dans le monde. But : Le but de cette étude est de définir les priorités en matière d'éducation et de recherche pour l'avenir, dans le but d'améliorer la gestion de la douleur chez les personnes plus âgées. De plus, les barrières existantes pour aborder ces priorités sont répertoriées. Méthodes : Cette étude à méthodologie mixte, fondée sur un processus Delphi modifié, comprenait trois composantes distinctes : (1) une composante qualitative ayant recours à des groupes de discussion réunissant des informateurs clés ou des experts du domaine de la gestion de la douleur chez les adultes plus âgés (n = 17); (2) une revue exploratoire de la littérature, et (3) un sondage comprenant des questions à réponses multiples hiérarchisées à laquelle ont répondu les mêmes informateurs qui avaient participé aux groupes de discussion. Une analyse thématique a ensuite été utilisée pour dresser la liste initiale de problèmes, qui ont ensuite été classés de manière hiérarchique à l'aide de statistiques descriptives. Résultats : Certaines préoccupations liées à la fois à l'éducation et à la recherche ont souvent été mentionnées par les participants. Pour l'éducation, ils ont relevé le besoin d'inclure davantage de contenu portant sur la documentation de la douleur, l'évaluation de la douleur et l'apprentissage des complexités de l...

Pain, comorbidities, and clinical decision-making: conceptualization, development, and pilot testing of the Pain in Aging, Educational Assessment of Need instrument

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“…Pain detection and treatment, however, continues to be a challenge for health care professionals (Bullock et al, ; Scherder et al, ; Schofield & Abdulla, ). Results indicate that pain in people with dementia is under‐detected as well as under‐treated (Benedetti et al, ; Herr & Titler, ; Kaasalainen et al, ; Scherder et al, ). Since consequences of undetected and untreated pain are severe (Hadjistavropoulos et al, ), a thorough assessment of pain is an essential prerequisite for an adequate and successful treatment (Corbett et al, ).…”

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