• Andrea Budnick, Ronny Kuhnert, Arlett Wenzel, Mimi Tse, Juliana Schneider, Reinhold Kreutz, and Dagmar Dräger.
• Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Berlin, Germany. Electronic address: andrea.budnick@charite.de.
• J Pain Symptom Manage. 2020 Jul 1; 60 (1): 48-59.

ContextThere are no available data regarding pain-associated clusters among nursing home residents (NHRs) and older adults receiving home care with chronic pain.ObjectivesTo identify and describe pain-associated clusters in NHRs and older adults receiving home care with chronic pain and to explore associations with clusters in both settings.MethodsWe surveyed 137 NHRs and 205 older adults receiving home care. Clusters were identified using hierarchical agglomerative cluster analysis, using Ward's method with squared Euclidean distances in the proximities matrix. The clusters were characterized based on sociodemographic and clinical characteristics. Multinomial logistic regression was used to identify variables associated with different clusters.ResultsIn each setting, we identified three clusters: pain relieved, pain impaired, and suffering severe pain. In the nursing home study and home care study, respectively, the participant distributions were 46.72% and 11.71% in the pain-relieved cluster, 22.63% and 33.66% in the pain-impaired cluster, and 30.66% and 54.63% in the severe-pain cluster. Appropriate pain medication was only detected among pain-relieved NHRs.ConclusionOverall, differences in pain management exist within the two care settings presented here. There is potential for improvement in both settings. Moreover, there exists a need for clinical interventions aiming at shifting from pain-affected clusters to pain-relieved status.Copyright © 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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