Quality of Life and Pain Medication Use in Persons With Advanced Dementia Living in Long-Term Care Facilities
| Autor: | Paulien H. van Dam, Wilco P. Achterberg, Dagrun D. Slettebo, Bettina S. Husebo, Monique A. A. Caljouw |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Occupational therapy
Male Quality of life medicine.medical_specialty paracetamol Pain medication Pain Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Activities of Daily Living Medicine Dementia Humans Pain Management 030212 general & internal medicine General Nursing Aged Aged 80 and over business.industry Norway Health Policy Confounding General Medicine Analgesics Non-Narcotic Middle Aged medicine.disease Long-Term Care Nursing Homes Long-term care nursing home Mood Cross-Sectional Studies Advanced dementia pain medication Physical therapy Female Geriatrics and Gerontology business 030217 neurology & neurosurgery dementia |
| Zdroj: | Journal of the American Medical Directors Association, 20(11), 1432-1437 |
| Popis: | Objectives In residents with dementia living in a long-term care facility (LTCF), un(der)treated pain may trigger behavioral disturbances, mood syndromes, and deterioration of physical functioning and self-maintenance. Because these factors can have considerable impact on the quality of life (QoL), this study aimed to (1) compare characteristics of persons with advanced dementia living in LTCFs with and without pain medication; (2) compare QoL in these persons with and without pain, stratified by type of pain medication use; and (3) explore associations between the use of paracetamol and QoL in persons with advanced dementia living in LTCFs. Design and setting This study analyzed baseline data from the Communication, Systematic Assessment and Treatment of Pain, Medication Review, Occupational Therapy, and Safety Study; a multicenter, cluster-randomized effectiveness-implementation clinical hybrid trial in 67 Norwegian LTCF clusters. Participants In total, 407 LTCF residents (rural and urban areas) aged ≥65 years, with Functional Assessment Staging scores of 5–7 (ie, moderate to advanced dementia). Main outcome measure QoL as assessed by the 6 QUALIDEM (validated questionnaire to measure QoL in persons with dementia living in LTCF) domains applicable to persons with moderate to severe dementia. The association between QoL and paracetamol was estimated using linear mixed-effect models, adjusting for confounding variables. Results 62.0% used pain medication (paracetamol, opioids, or both). QoL was lower in residents using pain medication, compared with those without pain medication [mean QUALIDEM score 68.8 (standard deviation 17.4 vs) 75.5 (standard deviation 14.6), respectively, P Conclusions and Implications Persons with advanced dementia living in LTCF using pain medication have a lower QoL compared with those not using pain medication. These results are of key importance for the clinician because they stress the need for regular medication review and pain management. When measured cross-sectionally, use of paracetamol is not associated with increased QoL. |
| Databáze: | OpenAIRE |
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