Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Pain and ED Use in Adults with Dementia

J Pain Symptom Manage; ePub 2018 Sep 14; Hunt, et al

Unmet need for pain management was associated with more frequent emergency department (ED) visits in the last month of life among older adults with dementia, a new study found. The mortality follow-back study included older adults with dementia in the National Health and Aging Trends Study (NHATS) who died between 2012-2014. Researchers found:

  • 281 NHATS decedents (mean age 86 years, 61% female, 81% white) with dementia met study criteria.
  • 57% had a least 1 ED visit in the last month of life; 46.5% had an ED visit resulting in a hospital admission.
  • 73% of decedents experienced pain in the last month of life, and 10% had an unmet need for pain management.
  • After adjustments, pain was not associated with increased ED use in the last month of life.
  • However, decedents with unmet need for pain management had an almost 50% higher rate of ED visits in the last month of life than those without unmet needs.

Citation:

Hunt LJ, Ritchie CS, Cataldo JK, Patel K, Stephens CE, Smith AK. Pain and emergency department use in the last month of life among older adults with dementia. [Published online ahead of print September 14, 2018]. J Pain Symptom Manage. doi:10.1016/j.jpainsymman.2018.09.005.

This Week's Must Reads

AHA Statement: Accurate Measurement of BP, Hypertension; ePub 2019 Mar 4; Muntner, et al

Coffee Consumption & Plasma Biomarkers, Am J Clin Nutr; ePub 2019 Mar 5; Hang, et al

Is Adding Aspirin to Warfarin Therapy Beneficial? , JAMA Intern Med; ePub 2019 Mar 4; Schaefer, et al

Urinary Oxalate Excretion & Risk of CKD Progression, JAMA Intern Med; ePub 2019 Mar 4; Waikar, et al

Psychosocial Stress & CV Health in Older Women, Circulation; ePub 2019 Feb 28; Burroughs-Peña, et al

Must Reads in Pain

Opioid-Related Mortality in US by Opioid Type, JAMA Netw Open; 2019 Feb 22; Kiang, et al

Disparities in the Prescription of Opioids, JAMA Intern Med; ePub 2019 Feb 11; Friedman, et al

Trends in Pain Prevalence in US Adults, J Pain; ePub 2019 Jan 15; Nahin, et al

Prescribed Opioids & Risk of CAP in Patients with HIV, JAMA Intern Med; 2019 Jan 7; Edelman, et al

Opioid-Involved Overdose Deaths in the US, MMWR; 2019 Jan 4; Scholl, Seth, et al