Daily pain that was excruciating at some time in the previous week: prevalence, characteristics, and outcomes in nursing home residents.
OBJECTIVE
To examine the prevalence, correlates, and consequences of nursing home (NH) staff reports of "excruciating" level of pain at some time in the previous week in persons with daily pain reported on the Minimum Data Set (MDS).


METHODS
Cross-sectional study.


METHODS
NHs in the United States.


METHODS
A total 2,138,442 persons who resided in 15,745 nursing homes in the United States.


METHODS
Pain reported as daily and at its most excruciating in the previous week on the MDS at initial and follow-up assessment. Associations were examined with demographic characteristics, functioning, and measures of disease burden reported on the MDS.


RESULTS
NH staff noted that 80,512 (3.7%) of residents had daily pain that was at one or more times excruciating in the previous week. This level of pain was more prevalent in younger residents. Nearly two-thirds (62.1%) of persons with this level of pain were no longer independent in activities of daily living, but 48.8% were rated to have normal cognitive status. In contrast, those without daily pain that was sometimes excruciating were less likely to be cognitively intact (25.7%P<.001) and less likely to have declined in their functioning (30.1%, P=.001). More than one in five with daily pain that was excruciating at times had a cancer diagnosis, and 21.5% experienced weight loss. Of the 24,300 persons with a second assessment, 10,284 (42.3%) still had excruciating pain at some time in the previous week.


CONCLUSIONS
NH residents with daily pain that was sometimes excruciating were younger and seriously ill with functional decline and weight loss. Too often, persons remain in this level of pain.
Teno
Joan M
JM
Department of Community Health, Brown Medical School, Providence, Rhode Island, New York, USA. Joan_Teno@brown.edu
Kabumoto
Glen
G
Wetle
Terrie
T
Roy
Jason
J
Mor
Vincent
V
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000503:physiopathology; D009735:Nursing Homes; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D010147:Pain Measurement; D015995:Prevalence; D011787:Quality of Health Care; D012494:Sampling Studies; D013997:Time Factors; D014481:United States; D015431:Weight Loss