Prescription and dosage of analgesic medication in relation to resident behaviors in the nursing home.
OBJECTIVE
To examine correlates of analgesic medication prescription and administration in communicative, cognitively impaired nursing home residents. Residents' behaviors were assessed using computer-assisted real-time observations as potential adjunctive indicators of pain.


METHODS
Cross-sectional study over a 4-week period.


METHODS
Five nursing homes in the greater Birmingham, Alabama, area.


METHODS
Ninety-two residents (mean age +/- standard deviation = 83.86 +/- 8.55) with a mean Mini-Mental State Examination (MMSE) score of 13.81 +/- 6.34.


METHODS
Data were obtained via chart review, resident assessments, questionnaire completion by certified nursing assistants familiar with residents' care, and direct observation of residents' daily behaviors.


RESULTS
Receipt of analgesic medication was related to self-report of pain (F2,89 = 9.89, P =.0001), MMSE (F2,88 = 3.98, P =.022), and time spent inactive (F2,89 = 3.04, P =.053). Residents who received analgesic medication reported greater intensity of pain than other residents. Residents who received analgesics had higher MMSE scores than those who did not receive analgesics. Residents who received analgesics spent less time being inactive than those not prescribed analgesics. Receipt of higher dosage of opioid analgesic medication was associated with more time spent with others in verbal interaction (r =.22, P =.03).


CONCLUSIONS
This study refines the methodology of measuring analgesic medication dosage and its effect on resident behavior. Analgesic prescription and administration patterns are related to time residents spend being inactive. Results suggest that opioid analgesics may hold particular promise in alleviating pain, as indicated by resident behaviors.
Allen
Rebecca S
RS
Department of Psychology and Applied Gerontology Program, University of Alabama, Tuscaloosa, Alabama 35487, USA. rsallen@hama.ua.edu
Thorn
Beverly E
BE
Fisher
Susan E
SE
Gerstle
John
J
Quarles
Karen
K
Bourgeois
Michelle S
MS
Dijkstra
Katinka
K
Burgio
Louis D
LD
D000368:Aged; D000369:Aged, 80 and over; D000407:Alabama; D000701:Analgesics, Opioid / Q000494:pharmacology* / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology* / Q000627:therapeutic use; D001519:Behavior / Q000187:drug effects*; D003072:Cognition Disorders; D003142:Communication; D003201:Computers; D003430:Cross-Sectional Studies; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D010146:Pain / Q000188:drug therapy
D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal