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dc.contributor.authorHunnicutt, Jacob N.
dc.contributor.authorTjia, Jennifer
dc.contributor.authorLapane, Kate L.
dc.date2022-08-11T08:11:04.000
dc.date.accessioned2022-08-23T17:30:29Z
dc.date.available2022-08-23T17:30:29Z
dc.date.issued2017-03-01
dc.date.submitted2017-03-06
dc.identifier.citation<p>J Pain Symptom Manage. 2017 Mar;53(3):561-570. doi: 10.1016/j.jpainsymman.2016.10.369. Epub 2016 Dec 29. <a href="https://doi.org/10.1016/j.jpainsymman.2016.10.369">Link to article on publisher's site</a></p>
dc.identifier.issn0885-3924 (Linking)
dc.identifier.doi10.1016/j.jpainsymman.2016.10.369
dc.identifier.pmid28042063
dc.identifier.urihttp://hdl.handle.net/20.500.14038/50528
dc.description.abstractCONTEXT: Pain management is suboptimal in nursing homes. OBJECTIVES: To estimate the extent to which receipt of hospice in nursing homes (NHs) increases the receipt of pain management for residents with cancer at the end of life. METHODS: Study participants included Medicare beneficiaries with cancer who were NH residents in the last 90 days of life in 2011-2012 (n = 78,160). Residents in pain on hospice were matched to like residents without hospice by facility, type of pain assessment (self-report/staff assessment), and weeks until death (9064 matched strata, 16,968 unique residents). Minimum Data Set 3.0 provided information on residents' pain prevalence and receipt of pain management (scheduled analgesics, as needed [pro re nata {PRN}] medication, nonpharmacologic interventions). We developed conditional logistic models to estimate the association between hospice use and pain management, stratified by self-reported and staff-assessed pain. RESULTS: We found that pain prevalence was higher in residents using hospice versus those without hospice (e.g., residents who self-reported pain: hospice: 59.9%, 95% CIs = 59.3%-60.5%; nonhospice: 50.0%, 95% CI = 49.4%-50.6%). In matched analyses, untreated pain was uncommon (self-reported pain: 2.9% and 5.6% in hospice users and nonusers, respectively). Hospice use was associated with receipt of scheduled analgesics (self-reported: adjusted odds ratio = 1.85, 95% CI = 1.73-1.971) and PRN medication (self-reported: adjusted odds ratio = 1.31, 95% CI = 1.20-1.43). Pain prevalence and the association between hospice and pain management were similar in residents with staff-assessed pain. CONCLUSION: Untreated pain at the end of life among residents with cancer in NHs is unusual. Hospice is associated with increased pain management among those with documented pain.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=28042063&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5337160/
dc.subjectUMCCTS funding
dc.subjectNursing home
dc.subjectcancer
dc.subjecthospice
dc.subjectpain
dc.subjectpain management
dc.subjectGeriatrics
dc.subjectHealth Services Administration
dc.subjectPain Management
dc.subjectPalliative Care
dc.subjectTranslational Medical Research
dc.titleHospice Use and Pain Management in Elderly Nursing Home Residents With Cancer
dc.typeJournal Article
dc.source.journaltitleJournal of pain and symptom management
dc.source.volume53
dc.source.issue3
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/umccts_pubs/96
dc.identifier.contextkey9794289
html.description.abstract<p>CONTEXT: Pain management is suboptimal in nursing homes.</p> <p>OBJECTIVES: To estimate the extent to which receipt of hospice in nursing homes (NHs) increases the receipt of pain management for residents with cancer at the end of life.</p> <p>METHODS: Study participants included Medicare beneficiaries with cancer who were NH residents in the last 90 days of life in 2011-2012 (n = 78,160). Residents in pain on hospice were matched to like residents without hospice by facility, type of pain assessment (self-report/staff assessment), and weeks until death (9064 matched strata, 16,968 unique residents). Minimum Data Set 3.0 provided information on residents' pain prevalence and receipt of pain management (scheduled analgesics, as needed [pro re nata {PRN}] medication, nonpharmacologic interventions). We developed conditional logistic models to estimate the association between hospice use and pain management, stratified by self-reported and staff-assessed pain.</p> <p>RESULTS: We found that pain prevalence was higher in residents using hospice versus those without hospice (e.g., residents who self-reported pain: hospice: 59.9%, 95% CIs = 59.3%-60.5%; nonhospice: 50.0%, 95% CI = 49.4%-50.6%). In matched analyses, untreated pain was uncommon (self-reported pain: 2.9% and 5.6% in hospice users and nonusers, respectively). Hospice use was associated with receipt of scheduled analgesics (self-reported: adjusted odds ratio = 1.85, 95% CI = 1.73-1.971) and PRN medication (self-reported: adjusted odds ratio = 1.31, 95% CI = 1.20-1.43). Pain prevalence and the association between hospice and pain management were similar in residents with staff-assessed pain.</p> <p>CONCLUSION: Untreated pain at the end of life among residents with cancer in NHs is unusual. Hospice is associated with increased pain management among those with documented pain.</p>
dc.identifier.submissionpathumccts_pubs/96
dc.contributor.departmentMorningside Graduate School of Biomedical Sciences
dc.contributor.departmentDepartment of Quantitative Health Sciences
dc.source.pages561-570
dc.description.thesisprogramClinical and Population Health Research


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