Bullock, L, Bedson, J, Jordan, JL, Bartlam, B, Chew-Graham, CA and Campbell, P (2019) Pain assessment and pain treatment for community-dwelling people with dementia: A systematic review and narrative synthesis. International Journal of Geriatric Psychiatry, 34 (6). pp. 807-821. ISSN 1099-1166

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To describe the current literature on pain assessment and pain treatment for community-dwelling people with dementia.

A comprehensive systematic search of the literature with narrative synthesis was conducted. Eight major bibliographic databases were searched in October 2018. Titles, abstracts, and full-text articles were sequentially screened. Standardised data extraction and quality appraisal exercises were conducted.

32 studies were included in the review, 11 reporting findings on pain assessment tools or methods, and 27 reporting findings on treatments for pain. In regard to pain assessment, a large proportion of people with moderate to severe dementia were unable to complete a self-report pain instrument. Pain was more commonly reported by informal caregivers than the person with dementia themselves. Limited evidence was available for pain focused behavioural observation assessment. In regard to pain treatment, paracetamol use was more common in community-dwelling people with dementia compared to people without dementia. However, non-steroidal anti-inflammatory drugs (NSAIDs) were used less. For stronger analgesics, community-dwelling people with dementia were more likely to receive strong opioids (e.g. fentanyl) than people without dementia.

This review identifies a dearth of high quality studies exploring pain assessment and/or treatment for community-dwelling people with dementia, not least into non-pharmacological interventions. The consequences of this lack of evidence, given the current and projected prevalence of the disease, are very serious and require urgent redress. In the meantime, clinicians should adopt a patient and caregiver centred, multi-dimensional, longitudinal approach to pain assessment and pain treatment for this population.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via Wiley at https://doi.org/10.1002/gps.5078 - Please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: analgesics; dementia; community; pain; pain assessment; pain treatment; pain measurement; pain management
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Related URLs:
Depositing User: Symplectic
Date Deposited: 12 Mar 2019 11:36
Last Modified: 20 May 2021 08:40
URI: https://eprints.keele.ac.uk/id/eprint/6045

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