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.


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