• Albert Lukas, Benjamin Mayer, Daniela Fialová, Eva Topinkova, Jacob Gindin, Graziano Onder, Roberto Bernabei, Thorsten Nikolaus, and Michael D Denkinger.
• Agaplesion Bethesda Clinic, Competence Center of Geriatrics and Aging Research, University of Ulm, Ulm, Germany. Electronic address: albert.lukas@bethesda-ulm.de.
• J Am Med Dir Assoc. 2013 Nov 1;14(11):821-31.

ObjectiveTo identify pharmacological and nonpharmacological pain management approaches and associated factors in nursing home residents across Europe.Setting, Participants, And MeasurementsCross-sectional study with 4156 residents who were assessed using the interRAI instrument for Long Term Care Facilities (interRAI LTCF), including pharmacological and nonpharmacological pain management modalities. Those reporting pain were included in the analyses (n = 1900). A deeper analysis was performed for the subsample of residents who reported "current pain," defined as pain at least 1 day within the past 3 days (n = 838), and those who reported "current pain of moderate to severe intensity" (n = 590).ResultsUp to 24% of residents who reported pain did not receive any pain medication and up to 11% received it only PRN (as-needed basis), independent of current pain-intensity levels; 61% did not receive any nonpharmacological treatment and 21% received neither pharmacological nor nonpharmacological pain modalities. Considerable differences could be demonstrated across European countries. Factors positively associated with pharmacological pain management were being of female gender, reporting cancer, and having moderate or severe pain. High turnover rates of regular staff and low-to-moderate physicians' availability were negatively associated. Factors positively associated with nonpharmacological treatment were fractures and need of assistance in activities of daily living. Dementia, large nursing home facilities, above-average and high turnover rates of nursing staff, a low physicians' availability, and severe pain intensity were negatively associated.ConclusionDespite some advances in recent years, pain treatment in European nursing home residents remains to be suboptimal and requires further improvement.Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

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