dc.contributor.author | Sandvik, Reidun Karin | en_US |
dc.contributor.author | Selbæk, Geir | en_US |
dc.contributor.author | Seifert, Reinhard | en_US |
dc.contributor.author | Aarsland, Dag | en_US |
dc.contributor.author | Ballard, Clive | en_US |
dc.contributor.author | Corbett, Anne | en_US |
dc.contributor.author | Husebø, Bettina Sandgathe | en_US |
dc.date.accessioned | 2014-12-08T13:05:18Z | en_US |
dc.date.accessioned | 2014-12-09T08:36:11Z | en_US |
dc.date.accessioned | 2014-12-10T10:35:49Z | |
dc.date.available | 2014-12-10T10:35:49Z | |
dc.date.issued | 2014-05-13 | eng |
dc.identifier.issn | 1090-3801 | |
dc.identifier.uri | https://hdl.handle.net/1956/8884 | |
dc.description.abstract | Background: Pain is frequent and distressing in people with dementia, but no randomized controlled trials have evaluated the effect of analgesic treatment on pain intensity as a key outcome. Methods: Three hundred fifty-two people with dementia and significant agitation from 60 nursing home units were included in this study. These units, representing 18 nursing homes in western Norway, were randomized to a stepwise protocol of treating pain (SPTP) or usual care. The SPTP group received acetaminophen, morphine, buprenorphine transdermal patch and pregabalin for 8 weeks, with a 4-week washout period. Medications were governed by the SPTP and each participant’s existing prescriptions. We obtained pain intensity scores from 327 patients (intervention n = 164, control n = 163) at five time points assessed by the primary outcome measure, Mobilization-Observation-Behaviour- Intensity-Dementia-2 (MOBID-2) Pain Scale. The secondary outcome was activities of daily living (ADL). We used a linear intercept mixed model in a two-way repeated measures configuration to assess change over time and between groups. Results: The SPTP conferred significant benefit in MOBID-2 scores compared with the control group [average treatment effect (ATE) −1.388; p < 0.001] at week 8, and MOBID-2 scores worsened during the washout period (ATE = −0.701; p = 0.022). Examining different analgesic treatments, benefit was conferred to patients receiving acetaminophen compared with the controls at week 2 (ATE = −0.663; p = 0.010), continuing to increase until week 8 (ATE = −1.297; p < 0.001). Although there were no overall improvements in ADL, an increase was seen in the group receiving acetaminophen (ATE = +1.0; p = 0.022). Conclusion: Pain medication significantly improved pain in the intervention group, with indications that acetaminophen also improved ADL function. | en_US |
dc.language.iso | eng | eng |
dc.publisher | Wiley | eng |
dc.rights | Attribution-NonCommercial-NoDerivs CC BY-NC-ND | eng |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/ | eng |
dc.title | Impact of a stepwise protocol for treating pain on pain intensity in nursing home patients with dementia: A cluster randomized trial | en_US |
dc.type | Peer reviewed | |
dc.type | Journal article | |
dc.date.updated | 2014-12-08T13:05:18Z | en_US |
dc.description.version | publishedVersion | en_US |
dc.rights.holder | Copyright 2014 The Authors | |
dc.identifier.doi | https://doi.org/10.1002/ejp.523 | |
dc.identifier.cristin | 1172014 | |
dc.source.journal | European Journal of Pain | |
dc.source.40 | 18 | |
dc.source.14 | 10 | |
dc.source.pagenumber | 1490-1500 | |