Current Pain Assessment Tools for Geriatric Patients Missing from Practices
MAY 11, 2013
Instead of building better assessment tools, Herr recommended refining and redeveloping existing ones to make them not only capture pain intensity, but also gauge patients’ function, tolerability, and satisfaction with treatment, which she said would improve pain recognition and treatment decision-making in older adults with severe cognitive impairment who can’t verbally communicate with their providers and often suffer from undertreated pain as a result.
“The pain intensity number scales do not provide information about pain tolerability, interference with daily activity, or need for treatment, and they don’t address the uniqueness in each person’s pain experience,” Herr said. “There’s also backlash from patients about ‘giving a number, a number, a number’ that doesn’t fully capture their experience with pain, so what we need is a more patient-centered approach.”
While two patient-centered approaches to initial pain assessment will soon be tested by the U.S. Department of Veterans Affairs and the University of Utah, Herr said knowledge about managing pain in the geriatric population is just as vital to advancing treatment and outcomes as tool transformations.
“There are many barriers to translating best practice recommendations, but I really believe what’s essential is education. Education and training to manage pain in the elderly right now is insufficient, and clinician training programs must address this serious deficiency,” Herr said. “Establishing core pain competencies as essential content in pre-licensure programs would be an important next step.”
Herr said UC Davis Health System is already taking that step with grant support from the Mayday Fund, as a team of faculty will design and implement a curriculum that aims to increase health care professionals’ knowledge and response to pain.