Acute Pain Management in Older Adults in the Emergency Department

Clinics in Geriatric Medicine

Volumn 29, Issue 1, 2013, Pages 151-164

  Hwang, Ula ^a,b   Platts Mills, Timothy F ^c  

^a MOUNT SINAI SCHOOL OF MEDICINE   (United States)

^b VETERANS AFFAIRS MEDICAL CENTER   (United States)

^c UNIVERSITY OF NORTH CAROLINA SCHOOL OF MEDICINE   (United States)

Author keywords

Analgesics; Emergency medicine; Geriatrics; Pain; Pain assessment

Indexed keywords

HYDROCODONE; HYDROMORPHONE; IBUPROFEN; KETOROLAC; MORPHINE; NAPROXEN; NARCOTIC ANALGESIC AGENT; NONSTEROID ANTIINFLAMMATORY AGENT; OXYCODONE; PARACETAMOL; TRAMADOL;

ANALGESIA; BREAKTHROUGH PAIN; CLINICAL EFFECTIVENESS; CLINICAL INDICATOR; CONSTIPATION; DISEASE SEVERITY; DIZZINESS; DROWSINESS; DRUG EFFICACY; DRUG HALF LIFE; DRUG SAFETY; DRUG TOLERABILITY; EMERGENCY CARE; EMERGENCY WARD; GASTROINTESTINAL TOXICITY; HUMAN; MUSCULOSKELETAL PAIN; NAUSEA AND VOMITING; NEPHROTOXICITY; OUTCOME ASSESSMENT; PAIN; PAIN ASSESSMENT; PATIENT ASSESSMENT; PATIENT SAFETY; REGIONAL ANESTHESIA; RETREATMENT; REVIEW; RISK ASSESSMENT; SOMNOLENCE;

ACUTE PAIN; AGED; AGED, 80 AND OVER; ANALGESICS; EMERGENCY SERVICE, HOSPITAL; EMERGENCY TREATMENT; GERIATRIC ASSESSMENT; HUMANS; PAIN MANAGEMENT; PAIN MEASUREMENT; QUALITY OF HEALTH CARE; RISK FACTORS; TREATMENT OUTCOME;

EID: 84870015875     PISSN: 07490690     EISSN: 18798853     Source Type: Journal    
DOI: 10.1016/j.cger.2012.10.006     Document Type: Review

References (72)

1. Platts-Mills T.F., Esserman D.A., Brown D.L., et al. Older US emergency department patients are less likely to receive pain medication than younger patients: results from a national survey. Ann Emerg Med 2012, 60(2):199-206.
2. Desbiens N., Mueller-Rizner N., Connors A., et al. Pain in the oldest-old during hospitalization and up to one year later. J Am Geriatr Soc 1997, 45:1167-1172.
3. Dworkin R. Which individuals with acute pain are most likely to develop a chronic pain syndrome?. Pain Forum 1997, 6:127-136.
4. Katz J., Jackson M., Kavanaugh B., et al. Acute pain after thoracic surgery predicts long-term post-thoracotomy pain. Clin J Pain 1996, 12:50-56.
5. Morrison R.S., Magaziner J., McLaughlin M.A., et al. The impact of post-operative pain on outcomes following hip fracture. Pain 2003, 103(3):303-311.
6. Duggleby W., Lander J. Cognitive status and postoperative pain: older adults. J Pain Symptom Manage 1994, 9:19-27.
7. Lynch E., Lazor M., Gelis J., et al. The impact of postoperative pain on the development of postoperative delirium. Anesth Analg 1998, 86:781-785.
8. Terrell K.T., Hui S.L., Castelluccio P., et al. Analgesic prescribing for patients who are discharged from an emergency department. Pain Med 2010, 11:1072-1077.
9. Jones J., Johnson K., McNinch M. Age as a risk factor for inadequate emergency department analgesia. Am J Emerg Med 1996, 14:157-160.
10. Heins J., Heins A., Grammas M., et al. Disparities in analgesia and opioid prescribing practices for patients with musculoskeletal pain in the emergency department. J Emerg Nurs 2006, 32:219-224.
11. Heins A., Grammas M., Heins J.K., et al. Determinants of variation in analgesic and opioid prescribing practice in an emergency department. J Opioid Manag 2006, 2:335-340.
12. Hwang U., Richardson L.D., Harris B., et al. The quality of emergency department pain care for older adult patients. J Am Geriatr Soc 2010, 58:2122-2128.
13. Iyer R.G. Pain documentation and predictors of analgesic prescribing for elderly patients during emergency department visits. J Pain Symptom Manage 2010, 41:367-373.
14. Arendts G., Fry M. Factors associated with delay to opiate analgesia in emergency departments. J Pain 2006, 7:682-686.
15. Platts-Mills T.F., Esserman D.A., Brown L., et al. Older US emergency department patients are less likely to receive pain medication than younger patients: results from a national survey. Ann Emerg Med 2012, 60:199-206.
16. Mills A.M., Edwards J.M., Shofer F.S., et al. Analgesia for older adults with abdominal or back pain in emergency department. West J Emerg Med 2011, 12:43-50.
17. Herr K., Titler M. Acute pain assessment and pharmacological management practices for the older adult with a hip fracture: review of ED trends. J Emerg Nurs 2009, 35:312-320.
18. Cinar O., Ernst R., Fosnocht D., et al. Geriatric patients may not experience increased risk of oligoanalgesia in the emergency department. Ann Emerg Med 2012, 60:207-211.
19. Wells N., Pasero C., McCaffery M. Improving the quality of care through pain assessment and management. patient safety and quality: an evidence-based handbook for nurses 2008, Agency for Healthcare Research and Quality, Rockville (MD).
20. Fine P.G. Treatment guidelines for the pharmacological management of pain in older persons. Pain Med 2012, 13(Suppl 2):s57-s66.
21. Silka P.A., Roth M.M., Moreno G., et al. Pain scores improve analgesic administration patterns for trauma patients in the emergency department. Acad Emerg Med 2004, 11:264-270.
22. Duignan M., Dunn V. Barriers to pain management in emergency departments. Emerg Nurse 2008, 15(9):30-34.
23. Rupp T., Delaney K. Inadequate analgesia in emergency medicine. Ann Emerg Med 2004, 43:494-503.
24. Hwang U., Jagoda A. Geriatric emergency analgesia. Emergency department analgesia 2008, 42-51. Cambridge University Press, Cambridge (UK). S. Thomas (Ed.).
25. Ware L.J., Epps C.D., Herr K., et al. Evaluation of the revised faces pain scale, verbal descriptor scale, numeric rating scale, and Iowa pain thermometer in older minority adults. Pain Manag Nurs 2006, 7(3):117-125.
26. Herr K., Spratt K., Mobiliy P., et al. Pain intensity assessment in older adults: use of experimental pain to compare psychometric properties and usability of selected pain scales with younger adults. Clin J Pain 2004, 20:207-219.
27. Herr K., Coyne P.J., Key T., et al. Pain assessment in the nonverbal patient: position statement with clinical practice recommendations. Pain Manag Nurs 2006, 7(2):44-52.
28. Herr K., Bjoro K., Decker S. Tools for assessment of pain in nonverbal older adults with dementia: a state-of-the-science review. J Pain Symptom Manage 2006, 31(2):170-192.
29. Abbey J., Piller N., De Belllis A., et al. The Abbey pain scale: a 1-minute numerical indicator for people with end-stage dementia. Int J Palliat Nurs 2004, 10(1):6-13.
30. Kovach C.R., Weissman D.E., Griffie J., et al. Assessment and treatment of discomfort for people with late-stage dementia. J Pain Symptom Manage 1999, 18(6):412-419.
31. Feldt K.S. The Checklist of nonverbal pain indicators (CNPI). Pain Manag Nurs 2000, 1:13-21.
32. Snow A.L., Weber J.B., O'Malley K.J., et al. NOPPAIN: a nursing assistant-administered pain assessment instrument for use in dementia. Dement Geriatr Cogn Disord 2004, 17(3):240-246.
33. Fuchs-Lacelle S., Hadjistavropoulos T. Development and preliminary validation of the pain assessment checklist for seniors with limited ability to communicate (PACSLAC). Pain Manag Nurs 2004, 5(1):37-49.
34. Zwakhalen S.M., Hamers J.P., Berger M.P. Improving the clinical usefulness of a behavioural pain scale for older people with dementia. J Adv Nurs 2007, 58:493-502.
35. Warden V., Hurley A.C., Volicer L. Development and psychometric evaluation of the pain assessment in advanced dementia (PAINAD) scale. J Am Med Dir Assoc 2003, 4(1):9-15.
36. Gelinas C., Fillion L., Puntillo K.A., et al. Validation of the critical-care pain observation tool in adult patients. Am J Crit Care 2006, 15(4):420-427.
37. Rat P., Jouve E., Pickering G., et al. Validation of an acute pain-behavior scale for older persons with inability to communicate verbally: algoplus. Eur J Pain 2011, 15(2). 198.e191-10.
38. Bjoro M., Herr K. Chapter 5-assessment of pain in the nonverbal and/or cognitively impaired older adults. Current therapy in pain 2009, 24-37. Saunders Elsevier, Philadelphia. H. Smith (Ed.).
39. Isaacs C.G., Kistler C., Hunold K.M., et al. Shared decision making in the selection of outpatient analgesics for older emergency department patients 2012, Society of Academic Emergency Medicine, Chicago.
40. Bowling C.B., O'Hare A.M. Managing older adults with CKD: individualized versus disease-based approaches. Am J Kidney Dis 2012, 59:293-302.
41. Isaacs CG, Kistler C, Hunold KM, et al. Shared decision making in the selection of outpatient analgesics for older emergency department patients. J Am Geriatr Soc, in press.
42. Beel T.L., Mitchiner J.C., Frederiksen S.M., et al. Patient preferences regarding pain medication in the ED. Am J Emerg Med 2000, 18:376-380.
43. Hwang U., Richardson L.D., Sonuyi T.O., et al. The effect of emergency department crowding on the management of pain in older adults with hip fracture. J Am Geriatr Soc 2006, 54:270-275.
44. Pines J.M., Hollander J.E. Emergency department crowding is associated with poor care for patients with severe pain. Ann Emerg Med 2008, 51:1-5.
45. American Geriatrics Society Panel on the Pharmacological Management of Persistent Pain in Older Persons Pharmacological management of persistent pain in older persons. J Am Geriatr Soc 2009, 57:1331-1346.
46. Watkins P.B., Kaplowitz N., Slattery J.T., et al. Aminotransferase elevations in healthy adults receiving 4 grams of acetaminophen daily: a randomized controlled trial. JAMA 2006, 296:87-93.
47. Weinecke T., Gotzsche P.C. Paracetamol versus nonsteroidal anti-inflammatory drugs for rheumatoid arthritis. Cochrane Database Syst Rev 2004, (1). CD003789.
48. American Geriatrics Society 2012 Beers criteria update expert panel American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 2012, 60(4):616-631.
49. Platts-Mills TF, Richmond NL, Hunold KM, et al. Life-threatening hyperkalemia following two days of ibuprofen. Am J Emerg Med, in press.
50. Whelton A., Stout R.L., Spilman P.S., et al. Renal effects of ibuprofen, piroxicam, and sulindac in patients with asymptomatic renal failure. A prospective, randomized, crossover comparison. Ann Intern Med 1990, 112(8):568-576.
51. Rainsford K.D. Profile and mechanisms of gastrointestinal and other side effects of nonsteroidal anti-inflammatory drugs (NSAIDs). Am J Med 1999, 107(6A):27S-35S.
52. Rostom A., Dube C., Wells G., et al. Prevention of NSAID-induced gastrodudenal ulcers. Cochrane Database Syst Rev 2002, (4). CD0022960.
53. Abrahm J.L. Advances in pain management for older adult patients. Clin Geriatr Med 2000, 16:269-311.
54. Chang A.K., Bijur P.E., Baccelieri A., et al. Efficacy and safety profile of a single dose of hydromorphone compared with morphine in older adults with acute, severe pain: a prospective, randomized, double-blind clinical trial. Am J Geriatr Pharmacother 2009, 7:1-10.
55. Barkin R., Barkin S., Barkin D. Perception, assessment, treatment, and management of pain in the elderly. Clin Geriatr Med 2005, 21:465-490.
56. Shorr R.I., Griffin M.R., Daughterty J.R., et al. Opioid analgesics and the risk of hip fracture in the elderly: codeine and propoxyphene. J Gerontol 1992, 47:M111-M115.
57. Turturro M.A., Paris P.M., Yealy D.M., et al. Hydrocodone versus codeine in acute musculoskeletal pain. Ann Emerg Med 1991, 20(10):1100-1103.
58. Huang A.R., Mallet L., Rochefort C.M., et al. Medication-related falls in the elderly: causative factors and preventive strategies. Drugs Aging 2012, 29:359-376.
59. Vassallo M., Stockdale R., Sharma J.C., et al. A comparative study of the use of four fall risk assessment tools on acute medical wards. J Am Geriatr Soc 2005, 53:1034-1038.
60. Bohnert A.S., Valenstein M., Bair M.J., et al. Association between opioid prescribing patterns and opioid overdose-related deaths. JAMA 2011, 305:1315-1321.
61. Chan B.K., Tam L.K., Wat C.Y., et al. Opioids in chronic non-cancer pain. Expert Opin Pharmacother 2011, 12:705-720.
62. Blackwell S.A., Montgomery M.A., Waldo D., et al. National study of medications associated with injury in elderly Medicare/Medicaid dual enrollees. J Am Pharm Assoc 2003, 49(6):751-759.
63. Solomon D.H., Rassen J.A., Glynn R.J., et al. The comparative safety of opioids for nonmalignant pain in older adults. Arch Intern Med 2010, 170:1979-1986.
64. Solomon D.H., Rassen J.A., Glynn R.J., et al. The comparative safety of analgesics in older adults with arthritis. Arch Intern Med 2010, 170:1968-1976.
65. Hwang U., Morrison R.S., Richardson L.D., et al. A painful setback: misinterpretation of analgesic safety in older adults may inadvertently worsen pain care. Arch Intern Med 2011, 171(12):1127.
66. Beaudoin F.L., Nagdev A., Merchant R.C., et al. Ultrasound-guided femoral nerve blocks in elderly patients with hip fractures. Am J Emerg Med 2010, 28(1):76-81.
67. Abbasi M., Dehghani M., Keefe F.J., et al. Spouse-assisted training in pain coping skills and the outcome of multidisciplinary pain management for chronic low back pain treatment: a 1-year randomized controlled trial. Eur J Pain 2012, 16(7):1033-1043.
68. Keefe F.J., Blumenthal J., Baucom D., et al. Effects of spouse-assisted coping skills training and exercise training in patients with osteoarthritic knee pain: a randomized controlled study. Pain 2004, 110(3):539-549.
69. Morley S., Eccleston C., Williams A. Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache. Pain 1999, 80(1-2):1-13.
70. Waters S.J., Woodward J.T., Keefe F.J. Cognitive-behavioral therapy for pain in older adults. Pain in older persons, progress in pain research and management 2005, vol. 35:239-261. IASP Press, Seattle (WA).
71. Wenger N., Shekelle P. Assessing care of vulnerable elders: ACOVE project overview. Ann Intern Med 2001, 135(8 Part 2):642-646.
72. Terrell K.T., Hustey F.M., Hwang U., et al. Quality indicators for geriatric emergency care. Acad Emerg Med 2009, 16:441-450.