The Use of Nonpharmacologic Approaches to Pain Management Among Nursing Home Residents.
Barbara Resnick, Rachel McPherson, Nayeon Kim and 2 others
PMID 41390293WHAT IT FOUND
Most nursing home residents with dementia received at least one nonpharmacologic pain approach; positioning was the most common.
More approaches were associated with more oral pain medicines, diabetes, and less cognitive impairment. The study did not show these approaches reduced pain.
Key findings
01Most residents received at least one nonpharmacologic intervention (76%), with a mean of 2.0 interventions.
02Higher use of nonpharmacologic interventions was associated with more oral pain medications, diabetes, and less cognitive impairment; together these factors accounted for 10% of the differences in number of interventions.
03Age, race, ethnicity, gender, musculoskeletal disease, and neurological disease were not associated with the number of nonpharmacologic interventions received.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used baseline data from six nursing home communities and 136 residents, so it may not represent all nursing homes. It did not evaluate whether nonpharmacologic interventions reduced pain. Pain was assessed by observation during activity and may miss residents who show few visible signs. Chart documentation may have undercounted nonpharmacologic use. Creams and patches were counted as nonpharmacologic, and it was not always clear whether patches contained lidocaine or only nonpharmaceutical ingredients. It did not account for provider knowledge, beliefs, resources, staffing, or hospice status. The design was cross-sectional, so it could not tell whether interventions were started before or after pain or medication treatment.
Declared interests
The authors declared no conflicts of interest. The article is listed as supported by NIH extramural research funding.
The easy way to misread this
Do not read this as proof that nonpharmacologic approaches work for pain. The study only described what was used and tested associations, so it could not show whether positioning, ointments, activity, or other approaches reduced pain.