Does Routine Pain Assessment Result in Better Care?

Hadjistavropoulos, Thomas; MacNab, Ying C.; Lints-Martindale, Amanda C.; Martin, R. Bruce; Hadjistavropoulos, Heather D.

doi:10.1155/2009/638585

Cited by 21 publications

(18 citation statements)

References 24 publications

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“…Two patients—1 female (33) multiple sclerosis; 1 male (58) severe multiple traumaQuantitative descriptivedos Santos Silva et al [42]BrazilNon-randomised controlled trial; patients’ medical reportsTo test the hypothesis that training for nurses of applying a systematised pain assessment of pain control effects decision-making regarding administration of morphine and affects pain relief for patientsNumeric Pain Rating Scale—pain levelCardiac Surgery. n = 182 Cardiac surgery patients; mean age—55.7Correlation of variables—Chi-square, Likelihood Ratio Test; Descriptive statistics; Comparison among groups—Kruskal–Wallis and Dunn testHadjistavropoulos et al [44]CanadaNon-randomised controlled trial; patient-reported outcome measuresTo assess whether systematic pain assessment changes the clinical practice of medical practitioners21-point box scale*—pain levels, Geriatric Pain Measure (GPM)*—pain intensity, Geriatric Depression Scale (GDS-SF)*—depressionGeneral Practice. n = 114 seniors with complex medical problems; mean age–80.74T testsHvitfeldt et al [33]USA/SwedenMixed-method—qualitative description and cross-sectional analytic study (triangulation design); questionnaires; Semi-structured interviewsTo identify the properties of a patient-reported measurement system in two different contexts.Oswestry Disability Index*—low back pain disability, SF-36*—health-related quality of life, Musculoskeletal Outcomes and Data Evaluation and Management System (MODEMS)—unknown1 Spine Centre (USA); 2 Rheumatology Clinics (Sweden). n = 88 clinical patients; n = 18 healthcare providers (15 MDs, 2 physiotherapists, 2 nurse practitioners)Quantitative data—Fisher’s exact 2-tailed test; qualitative data—Content analysisKazis et al [39]USARandomised controlled trial; questionnaires, patients’ medical recordsTo investigate the value of health status information on clinical practice for patients with rheumatoid arthritis.Arthritis Impact Measurement Scales (AIMS)*—physical, social and emotional wellbeing, Modified Health Assessment Questionnaire (MHAQ)*—health statusArthritis Centres.…”

Section: Resultsmentioning

confidence: 99%

“…Another study, which issued nurses with training on PROMs and implemented PROMs across a cardiac surgery ward, found that after training and implementation, patients had higher morphine consumption [42]. In comparison, three studies showed no significant differences in medication across intervention and control groups [39, 43, 44]. No significant differences were found in additional treatment [43], arthritis referrals [39], or reducing doctor visits [39].…”

Section: Resultsmentioning

confidence: 99%

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The impact of patient-reported outcome measures in clinical practice for pain: a systematic review

et al. 2016

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PurposePatient-reported outcome measures (PROMs) have increasingly been incorporated into clinical practice. Research suggests that PROMs could be viewed as active components of complex interventions and may affect the process and outcome of care. This systematic review examines PROMs in the context of treatment for non-malignant pain.MethodsAn electronic search on: MEDLINE, EMBASE, PsycINFO, PsycARTICLES, Cochrane Library and Web of Science identified relevant papers (February 2015). The inclusion criteria were: focused on implementing PROMs into clinical practice, adults, and primary data studies. Critical interpretive synthesis was used to synthesise qualitative and quantitative findings into a theoretical argument.ResultsThirteen eligible studies were identified. Synthesis suggested that PROMs may be included in the initial consultation to assess patients and for shared decision-making regarding patient care. During the course of treatment, PROMs can be used to track progress, evaluate treatment, and change the course of care; using PROMs may also influence the therapeutic relationship. Post-treatment, using PROMs might directly influence other outcomes such as pain and patient satisfaction. However, although studies have investigated these areas, evidence is weak and inconclusive.ConclusionDue to the poor quality, lack of generalisability and heterogeneity of these studies, it is not possible to provide a comprehensive understanding of how PROMs may impact clinical treatment of non-malignant pain. The literature suggests that PROMs enable pain assessment, decision-making, the therapeutic relationship, evaluation of treatment and may influence outcomes. Further research is needed to provide better evidence as to whether PROMs do indeed have any effects on these domains.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The impact of patient-reported outcome measures in clinical practice for pain: a systematic review

et al. 2016

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“…Use of pain tools may improve pain treatment [179,180]. The Pain Assessment in Advanced Dementia (PAINAD), developed in the US, is a brief tool (5 items) for direct observation including by observers unfamiliar with the patient [131].…”

Section: Toolsmentioning

confidence: 99%

Dying with Dementia: What We Know after More than a Decade of Research

Steen

2010

JAD

225

177

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Abstract. Death with dementia is increasingly common. Although prognostication is difficult, it is an incurable life-limiting illness for which palliative care for the patient is often appropriate. Dementia patients are otherwise at risk of overtreatment with burdensome and possibly non-beneficial interventions and undertreatment of symptoms. Although recent studies indicate encouraging trends of improved palliative care, little evidence supports effectiveness of specific treatments. As of January 2010, at least 45 studies, almost all performed after 2000, have reported on treatment, comfort, symptom burden, and families' satisfaction with care. Over half (25; 56%) of these studies were in US settings, and most were small or retrospective. Few randomized trials and prospective observational studies have been performed so far, but several promising studies have been completed recently or are underway in various countries. Guidelines for care and treatment, still mostly consensus-based, support the benefits of advance care planning, continuity of care, and family and practitioner education. Assessment tools for pain, prognosis, and family evaluations of care have been developed and some have been shown to be effective in clinical practice. With increasing numbers of well-designed, large-scale studies, research in the next decade may result in better evidence-based guidelines and practice.

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“…53 The literature indicates that the mere availability of systematic pain assessment data may not be sufficient to affect clinical decision making. 54 Furthermore, qualitative studies report that many clinicians wish to be involved in planning outcome assessment protocols. 55 This study purposefully sought input from a variety of pediatric pain clinicians to evaluate usefulness of the PQ and to determine the best route for future implementation.…”

Section: Discussionmentioning

confidence: 99%