Pain as a challenge in nursing home residents with behavioral and psychological symptoms of dementia

Figures & data

Table 1 The distribution of pain routine treatment in all studied subjects – patients were grouped based on the strongest analgesic type

Routine step 1 : nonopioids				Routine step 2: weak opioids				Routine step 3: strong opioids
Schedule of treatment	Name of the drug and the daily dosage	APS	CMAI	Schedule of treatment	Name of the drug and the daily dosage	APS	CMAI	Schedule of treatment	Name of the drug and the daily dosage	APS	CMAI
Acetaminophen	Acetaminophen 500 mg 1. 1-0-0 2. 1-0-1 3. 1-0-1 4. 1-0-0 5. 1-0-1 6. 1-0-0 7. 1-0-1 8. 1-0-1 9. 0-0-1 10. 1-1-1	3 4 0 6 0 3 2 1 8 0	29 32 52 57 44 32 46 32 51 39		Tramadol 37.5 mg/acetaminophen 325 mga 1. 1-0-1 2. 1-0-1 3. 1-0-1 4. 1-0-1 5. 1-0-1	16 0 0 9 2	80 31 29 35 35		Buprenorphine 35 μg/hb 1 patch/3 days	117	57
									Buprenorphine 52.5 fig/hb 1 patch/3 days	7	29
									Buprenorphine 35 fig/hb 1 patch/3 day + naproxen 250 mg: 0-0-1	13	29
NSAIDs	Ibuprofen 200 mg: 1-0-0	6	34		Tramadol 75 mg/acetaminophen 650 mga1. 0-0-1 2. 1-0-1	7 11	29 45
	Diclofenac 150 mg: 1-0-0	6	47		Tramadol 37.5 mg/acetaminophen 325 mg:a 1-0-1 + diclofenac 50 mg: 1-0-0	1	29
	Diclofenac 75 mg: 1-0-0	1	32		Tramadol 75 mg/acetaminophen 650 mg:a 0-0-1	12	29
	Naproxen 250 mg: 1 -0-0	14	70

Note:

a One therapeutic formula,

b transdermal patch.

Abbreviations: APS, Abbey Pain Scale; CMAI, Cohen–Mansfield Agitation Inventory Scale; NSAID, nonsteroidal anti-inflammatory drug.

Figure 1 Relationship between pain and behavioral disturbances, N=96.

Abbreviations: APS, Abbey Pain Scale; CMAI, Cohen–Mansfield Agitation Inventory Scale.

Table 2 The characteristics of studied subjects divided based on CMAI

	Group 1 (n=57) Mean (SD) Median (range)	Group 2 (n=39) Mean (SD) Median (range)	p-value
Age (years)	83.3 (9.0)	84.8 (8.3)	ns
	85 (65–104)	86 (65–98)
Gender (Males)	11	7	ns
Length of institutionalization (months)	63.5 (54.8)	42.7 (35.0)	ns
	52 (1–222)	32 (6–162)
Barthel scale	23.9 (28.1)	26.2 (28.0)	ns
	10 (5–95)	10 (5–95)
AMTS	1.1 (1.9)	1.2 (2.0)	ns
	0 (0–6)	0 (0–6)
APS	3.0 (3.3)	6.2 (4.9)	p<0.01
	2 (0–13)	6 (0–17)
Number of drugs used	6.0 (3.0)	6.0 (2.6)	ns
	6 (0–13)	6 (1–13)
Number of subjects receiving routine analgesicsa	15	11	ns
Number of subjects receiving sedatives	30	33	p<0.001
Number of subjects receiving benzodiazepines	9	17	p<0.001
Number of subjects receiving neuroleptics	24	21	ns
Number of subjects receiving hydroxyzine	5	7	ns

Note:

a Subjects with both routine and routine and as needed analgesics were included.

Abbreviations: AMTS, Abbreviated Mental Test Score; APS, Abbey Pain Scale; CMAI, Cohen–Mansfield Agitation Inventory Scale; ns, not significant.