Inadequate prescribing practices lead to poor pain control in nursing home residents

Researchers have discovered that many nursing home residents have poorly controlled pain due to inadequate medication treatment. The results of the study are published in the Journal of the American Geriatrics Society.

An interdisciplinary team of researchers designed and tested a Nursing Home Pain Medication Appropriateness Scale (PMAS) to screen the overall suitability of prescribing practices for pain in a nursing home setting. They compared the direct resident pain assessments conducted by trained research assistants to the pain medications prescribed.

Data revealed the mean total PMAS was 64 percent of optimal, suggesting a generally poor score. In fact, they found that less than half of residents with predictably recurrent pain were being prescribed scheduled pain medication; 23 percent received at least one high-risk medication. PMAS scores were better for residents who were not in pain and in homes where the nurses' knowledge improved or stayed the same during an intervention designed to improve nursing homes' pain management practices.

"The inclusion of pain as a quality measure for both short-term and long-term residents is intended to provide an incentive for nursing homes to improve their practices in this area," say researchers. "The use of evidence-based process measures will permit an organization to begin addressing persistent problems in pain management."

According to the American Geriatrics Society Panel on Persistent Pain in Older Persons, 45 to 80 percent of nursing home residents have substantial pain. The consequences of poor pain management include sleep deprivation, poor nutrition, depression, anxiety, agitation, decreased activity, delayed healing and lower overall quality of life.


This study is published in the Journal of the American Geriatrics Society. For more information on this topic and to read additional patient-friendly summaries of articles in the Journal of the American Geriatrics Society, please visit

Media who would like to receive a PDF of the study please contact [email protected].

Corresponding author of the study, Evelyn Hutt, MD, is a practicing physician at the Denver VA Medical center and University of Colorado Health Science Center. She can be reached for questions and interviews at [email protected].

About the Journal
The primary goal of the Journal of the American Geriatrics Society is to publish articles that are relevant in the broadest terms to the clinical care of older persons. Such articles may span a variety of disciplines and fields and may be of immediate, intermediate, or long-term potential benefit to clinical practice.

About the Society
The American Geriatrics Society (AGS) is the premier professional organization of health care providers dedicated to improving the health and well-being of all older adults. With an active membership of over 6,000 health care professionals, the AGS has a long history of effecting change in the provision of health care for older adults. In the last decade, the Society has become a pivotal force in shaping attitudes, policies and practices regarding health care for older people.

About Blackwell Publishing
Blackwell Publishing is the world's leading society publisher, partnering with more than 665 academic, medical, and professional societies. Blackwell publishes over 800 journals and, to date, has published close to 6,000 text and reference books, across a wide range of academic, medical, and professional subjects.

Last reviewed: By John M. Grohol, Psy.D. on 30 Apr 2016
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