• 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, Germany. albert.lukas@bethesda-ulm.de
• J Am Med Dir Assoc. 2013 Jun 1;14(6):421-8.

Objective And DesignFew studies have compared cross-national characteristics of residents with pain in European long term care facilities. The SHELTER project, a cross-national European study on nursing home residents, provides the opportunity to examine this issue. The present study aimed to evaluate key figures about pain and compare them with seven European countries and Israel.Setting, Participants, And MeasurementsA total of 3926 nursing home residents were assessed by the interRAI instrument for Long Term Care Facilities (interRAI LTCF). Prevalence of pain, frequency, intensity, consistency, and control were estimated and compared cross-nationally. Correlates between patient-related characteristics and inadequate pain management were tested using bivariate and multivariate logistic regression models.ResultsOverall, 1900 (48.4%) residents suffered from pain. Pain prevalence varied significantly among countries, ranging from 19.8% in Israel to 73.0% in Finland. Pain was positively associated with female gender, fractures, falls, pressure ulcers, sleeping disorders, unstable health conditions, cancer, depression, and number of drugs. It was negatively associated with dementia. In a multivariate logistic regression model, all associations remained except for sleeping disorders. Clinical correlations varied considerably among countries. Although in 88.1% of cases, pain was self-rated by the residents as sufficiently controlled, in only 56.8% of cases was pain intensity self-rated as absent or mild. Pain control and intensity improved within 1 year.ConclusionPain prevalence is high and varies considerably across Europe. Although most residents considered pain as adequately controlled, a closer look confirmed that many still suffer from high pain intensities. Analyzing the reasons behind these differences may help to improve pain management.Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

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