title: Prevalence of pain in institutionalized adults with intellectual disabilities: a cross-sectional approach.
abstract: Information about pain prevalence in institutionalized individuals with intellectual disabilities is scarce, most likely because communication problems impede pain assessment. We aimed to inventory pain prevalence and actual pain management in intellectually disabled individuals living in a representative special care facility in the Netherlands. Caregivers rated the residents' present pain and overall pain during the preceding week on an 11-point numerical rating scale (NRS-11). In addition, behavioral pain assessment was performed with validated pain scales; the Rotterdam Elderly Pain Observation Scale (REPOS) or Checklist Pain Behavior (CPG). Ratings suggested that 47 of the 255 included residents (18%) suffered from pain either at present or during the preceding week, 14 of whom (30%) experienced pain on both occasions. Most of these 47 (85%) residents with pain had no analgesic prescription, not even in the case of severe pain (NRS 7 or higher). Ratings for nearly one out of every five residents suggested they suffered pain. This proportion is lower than in other studies and could imply that caregivers probably underestimate residents' prevalence of pain. Pain treatment might be inadequate in light of the low percentage of analgesic prescriptions. To prevent unnecessary suffering in institutes for residents with an intellectual disability (ID) we recommend use of a pain protocol including a validated pain measurement instrument.
authors.affiliation: Intensive Care and Department of Pediatric Surgery, Erasmus MC - Sophia Children's Hospital, University Medical Center, Box 2040, 3000 CA Rotterdam, The Netherlands. a.boerlage@erasmusmc.nl
authors.forename: Anneke A
authors.initials: AA
authors.lastname: Boerlage
authors.forename: Abraham J
authors.initials: AJ
authors.lastname: Valkenburg
authors.forename: Erik J A
authors.initials: EJ
authors.lastname: Scherder
authors.forename: Gertrud
authors.initials: G
authors.lastname: Steenhof
authors.forename: Peter
authors.initials: P
authors.lastname: Effing
authors.forename: Dick
authors.initials: D
authors.lastname: Tibboel
authors.forename: Monique
authors.initials: M
authors.lastname: van Dijk
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009735:Nursing Homes; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D059408:Pain Management; D010147:Pain Measurement; D015995:Prevalence; D055815:Young Adult
chemical_list: D000700:Analgesics