Management of Chronic Pain in Nursing Homes: Navigating Challenges to Improve Person-Centered Care. (Record no. 6029)

MARC details
000 -LEADER
fixed length control field 03346nam a22003137a 4500
008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION
fixed length control field 210217s20212021 xxu||||| |||| 00| 0 eng d
022 ## - INTERNATIONAL STANDARD SERIAL NUMBER
International Standard Serial Number 1525-8610
024 ## - OTHER STANDARD IDENTIFIER
Standard number or code 10.1016/j.jamda.2020.12.029 [doi]
024 ## - OTHER STANDARD IDENTIFIER
Standard number or code S1525-8610(20)31096-3 [pii]
040 ## - CATALOGING SOURCE
Original cataloging agency Ovid MEDLINE(R)
099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC)
PMID 33497656
245 ## - TITLE STATEMENT
Title Management of Chronic Pain in Nursing Homes: Navigating Challenges to Improve Person-Centered Care.
251 ## - Source
Source Journal of the American Medical Directors Association. 2021 Jan 23
252 ## - Abbreviated Source
Abbreviated source J AM MED DIR ASSOC. 2021 Jan 23
253 ## - Journal Name
Journal name Journal of the American Medical Directors Association
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Year 2021
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Manufacturer FY2021
265 ## - SOURCE FOR ACQUISITION/SUBSCRIPTION ADDRESS [OBSOLETE]
Publication status aheadofprint
266 ## - Date added to catalog
Date added to catalog 2021-02-17
520 ## - SUMMARY, ETC.
Abstract Despite the dynamic demands in the nursing home (NH), a definitive approach to managing chronic pain in older adults has yet to be established. Due to concerns for potential adverse pharmacologic effects, balancing appropriate pain management is a challenge among NH residents. The challenges encompass but are not limited to medical complexities, functional disabilities, and physical frailty. Barriers to the successful implementation of a comprehensive chronic pain management at the NH may include ambiguous directions on specific therapeutic interventions, insufficient guidance on treatment duration, and limited available treatment options. The Centers for Medicare and Medicaid Services' reporting requirement of adequate pain control among NH residents coupled with widely variable clinician-prescribing habits highlights the difficulties in overcoming the preceding challenges and barriers. The Coronavirus Disease 2019 (COVID-19) pandemic has further complicated pain management due to its negative consequences on well-being of residents of NHs. Associated symptoms of psychosocial stress, anxiety and depression, and chronic pain symptoms can exacerbate during the COVID-19 pandemic, leading to increased requirement for pain medications including but not limited to opioids. Pain is a multidimensional symptom and requires a strategic multimodal approach for its management. Nonpharmacologic modalities are underutilized in the NH setting and are the preferred first steps for mild pain, and nonopioid pharmacological agents can be added as a second step for a synergistic effect for moderate to severe pain. Opioids should be used as a last resort. Short-acting opioids are preferred over extended-release/long-acting opioids for chronic pain. Clinicians are encouraged to engage residents in proactive strategies in managing their pain, and to set realistic expectations toward improving their quality of life, as complete elimination of pain is not feasible in most cases. This review article provides the interdisciplinary team with a contemporary perspective of the multitude of changes and challenges influencing the prescribing as well as deprescribing of various pain medications. Copyright (c) 2020. Published by Elsevier Inc.
546 ## - LANGUAGE NOTE
Language note English
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element IN PROCESS -- NOT YET INDEXED
656 ## - INDEX TERM--OCCUPATION
Department MedStar Center for Successful Aging
657 ## - INDEX TERM--FUNCTION
Medline publication type Journal Article
700 ## - ADDED ENTRY--PERSONAL NAME
Local Authors Brandt, Nicole
790 ## - Authors
All authors Brandt N, Elon RD, Sheikh F, Vinh D
856 ## - ELECTRONIC LOCATION AND ACCESS
DOI <a href="https://dx.doi.org/10.1016/j.jamda.2020.12.029">https://dx.doi.org/10.1016/j.jamda.2020.12.029</a>
Public note https://dx.doi.org/10.1016/j.jamda.2020.12.029
942 ## - ADDED ENTRY ELEMENTS (KOHA)
Koha item type Journal Article
Item type description Article
Holdings
Withdrawn status Lost status Damaged status Not for loan Collection Home library Current library Date acquired Total Checkouts Full call number Barcode Date last seen Price effective from Koha item type
          MedStar Authors Catalog MedStar Authors Catalog 02/17/2021   33497656 33497656 02/17/2021 02/17/2021 Journal Article

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