Analgesic load, pain and daytime sedation in people with dementia in aged care facilities.
Alleviating suffering and maintaining quality of life are key objectives of providing care to people with dementia. However, people with dementia may experience and express pain indifferent ways to people without dementia. For this reasonpeople with dementia are typically prescribed less pain-relieving medicines than people without dementia. Pain expressed as behavioural symptoms is distressing for patients and carers. Behavioural symptoms may prompt clinicians to inappropriately prescribe psychotropic medicines (e.g. antipsychotics, hypnotic medicines). These medicines may be associated with adverse effects including excess sedation, falls and fractures, and an increased risk of death. Further research is needed to better understand the relationship between use of pain-relieving medicines, pain and daytime sedation. The results of this research will be used to produce geometric frameworks to provide patients, carers and clinicians with a visual representation of the association between use of pain-relieving medicines, pain and daytime sedation. This will provide valuable guidance and support to clinicians (e.g. general practitioners, nurses, pharmacists) who provide care to people with dementia.
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Lalic S, Kris M. Jamsen KM, Wimmer BC, Tan ECK, Hilmer SN, Robson L, Emery T, Bell JS. (2016). Polypharmacy and medication regimen complexity as factors associated with staff informant rated quality of life in residents of aged care facilities: a cross-sectional study. European Journal of Clinical Pharmacology, 72(9), 1117-1124. http://link.springer.com/article/10.1007%2Fs00228-016-2075-4
Lalic S, Sluggett JK, Ilomaki J, Wimmer BC, Tan ECK, Robson L, Emery T, Bell JS. (2016). Polypharmacy and medication regimen complexity as risk factors for hospitalization among residents of long-term care facilities: A prospective cohort study. JAMDA, 17(11), 1067.e1-1067.e6. http://www.sciencedirect.com/science/article/pii/S1525861016303711
Lalic S, Wimmer BC, Robson L, Bell JS. (2016). Satisfaction with care and health-related quality of life among residents of long-term care facilities. JAMDA, 17, 179-182. http://www.jamda.com/article/S1525-8610(15)00707-0/abstract
Herson M, Bell JS, Tan ECK, Emery T, Robson L, Wimmer BC. (2015). Factors associated with medication regimen complexity in residents of long-term care facilities. European Geriatric Medicine, 6, 561-564. http://www.sciencedirect.com/science/article/pii/S1878764915001953
Leung B, Jokanovic N, Tan ECK, Jamsen KM, Emery T, Manias E, Bell JS. (2015). Prescribed doses of opioids in long-term care facilities. JAMDA, 16, 1100-1102. http://www.jamda.com/article/S1525-8610(15)00595-2/abstract
Tan ECK, Visvanathan R, Hilmer SN, Robson L, Vitry AI, Quirke T, Emery T, Robson L, Shortt T, Sheldrick S, Lee S, Clothier R, Reeve E, Gnjidic D, Ilomaki J, Bell JS. (2014). Analgesic use, pain and daytime sedation in people with and without dementia in aged care facilities: A cross-sectional, multisite, epidemiological study protocol. BMJ Open, 4(6), e005757. doi: 10.1136/bmjopen-2014-005757. http://bmjopen.bmj.com/content/4/6/e005757
Dr Bell is Associate Professor, Centre for Medicine Useand Safety, Faculty of Pharmacy and Pharmaceutical Sciences at Monash University. He is also Adjunct Professor of Geriatric Pharmacotherapy, Faculty of Health Sciences at the University of Eastern Finland.