Skip to main content

Table 4 Assessment of mental status, pain and administered drugs

From: Drug-based pain management for people with dementia after hip or pelvic fractures: a systematic review

Author, year

Mental tests

Pain scales

Drugs

   

categorisation in the studies

assessment

COHORT STUDIES

 Adunsky et al. 2002 [10]

MMSE; CAM

-

morphine equivalents*1

retrospective survey of opioid consumption during entire hospitalisation

 Feldt et al. 1998 [33]

MMSE

FPEI; VDS; CNPI

morphine equivalents*2

retrospective chart review

 Feldt et al. 2000 [35]

 Feldt & Gunderson 2002 [29]

Grall 2010 [34]

ICD-9 codes

verbal: verbal pain intensity (24 h recall period) scores on W-BFPS *5

non-verbal: behavioral pain intensity Scores on the FLACC

physiological: changes in HR and SBP

acetaminophen equivalents

retrospective chart review

 Jensen-Dahm et al. 2016 [22]

chart review: ICD-8 & -10 codes

prescription of antidementia drugs

-

morphine equivalences

retrospective chart review

 McDermott et al. 2014 [26]

AMTS after arrival at emergency department

-

WHO analgesic ladder

retrospective chart review

 Morrison & Siu 2000 [12]

MMSE; CAM; Reisberg Global Deterioration Scale

VRS (daily assessment)

morphine equivalences

WHO analgesic ladder; Pain Management Index (PMI)

daily chart review

CROSS-SECTIONAL STUDIES

 Holdgate et al. 2010 [27]

ICD10-codes

no standardised pain scales (VAS, NRS, Likert scale)

-

retrospective chart review

 Hwang et al. 2006 [28]

patient self-reporting of Alzheimer’s disease or other dementia, or physician chart note of dementia

physician’s recording of pain evaluation or the reporting of pain in the patient history or during physical examination

opioid vs. non-opioid (NSAD, acetaminophen)

retrospective chart review

 Mak et al. 2011 [31]

MMSE, previously documented dementia;

-

morphine equivalences

retrospective chart review

 Titler et al., 2003 [32]

chart review → Medical Record Abstraction Form (MRAF) *3

nurse questionnaire *4

morphine equivalences

retrospective chart review

CASE SERIES

 Ardery et al. 2003 [21]

chart review → MRAF *3

nurse questionnaire *4

morphine equivalences

retrospective chart review

HEALTHCARE PROFESSIONALS´ SURVEYS

 Rantala & Kankkunen et al. 2012 [14]

-

behavioural observation; VAS, VRS, NRS; verbal assessment; facial pain scale; PAINAD

-

 Rantala & Kankkunen et al. 2014 [23]

 Rantala & Hartikainen et al. 2014 [25]

-

-

WHO analgesic ladder; *6

 Rantala & Hartikainen et al. 2014 [25]

  1. Mental tests: Mini Mental State Examination (MMSE); Confusion Assessment Method (CAM). Pain tests: Ferrell’s Pain Experience Interview (FPEI); Numeric Rating Scale (NRS); Visual Analog Scale (VAS); Verbal Descriptor Scale (VDS); Verbal Rating Scale (VRS); Checklist of Non-Verbal Pain Indicators (CNPI) — Modified form of the University of Alabama Pain Behaviour Scale; Pain Assessment in Advanced Dementia Scale (PAINAD). Others: Functional status index (FSI)
  2. *1 Examined only use of opioids, not simple analgesics such as paracetamol, 10 mg of intramuscular morphine were considered equal to 75 mg of intramuscular meperidine, and to 3 mg of oral morphine sulphate; *2 daily morphine equivalent calculations by Faherty & Grier, since all subjects were given acetaminophen, the daily administered dose was calculated separately; *3 similar to forms used in adherence to AHCPR Acute Pain Guidelines; *4 developed for this study; included a demographic section, the Perceived Stage of Adoption Instrument and the Barriers to Optimal Pain Management Scale; *5 W-BFPS: Wong-Baker FACES Pain Scale (modified by the Bapist Health Care System), FLACC Faces, Legs, Activity, Cry, Consolability, HR heart rate, SBP systolic blood pressure; *6 DDD (defined daily doses) by the Anatomical Therapeutic Chemical (ATC) Classification System recommended by WHO
Back to article page

BMC Geriatrics

ISSN: 1471-2318

Contact us