title: Evaluation of a behavioral assessment tool for the individual unable to self-report pain.
abstract: Assessment of pain intensity using a standard self-reported pain score is standard practice in most institutions. These instruments require the cognitive ability to process the pain intensity into a numeric or descriptive value. Many institutions are considering adopting an assessment tool for cognitive impairment. The purpose of this study is to evaluate a clinician-administered assessment tool, PAINAD, in patients with cognitive impairment. Opioid consumption and frequency of documented unknown pain were collected in 2 cognitive impaired groups. In the control group, a self-reporting pain intensity tool was used, and in a second group, the PAINAD was used. Opioid use was significantly higher (P = .003) and the rates of reported unknown pain were significantly lower (P < .01) in the group using the PAINAD instrument compared to the control group of patients with cognitive impairment. There were no noted differences in opioid-induced adverse reactions in either group.
authors.affiliation: Presbyterian Hospital of Dallas, 8200 Walnut Hill Lane, Pharmacy Department, Dallas, TX 75231, USA. robhutchison@texashealth.org
authors.forename: Rob W
authors.initials: RW
authors.lastname: Hutchison
authors.forename: William F
authors.initials: WF
authors.lastname: Tucker
authors.forename: Sunghyun
authors.initials: S
authors.lastname: Kim
authors.forename: Richard
authors.initials: R
authors.lastname: Gilder
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use; D003072:Cognition Disorders / Q000150:complications* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D010147:Pain Measurement / Q000379:methods* / Q000592:standards; D010166:Palliative Care / Q000379:methods* / Q000592:standards; D011446:Prospective Studies; D011594:Psychometrics; D015203:Reproducibility of Results; D012647:Self-Assessment; D012680:Sensitivity and Specificity
chemical_list: D000701:Analgesics, Opioid