Der Schmerz
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Multicenter Study Comparative Study
[Pain therapy in German long-term care facilities in a European comparison : Results of the SHELTER study].
A considerable number of nursing home residents suffering from pain are insufficiently treated. International comparisons of pain management in German (GER) and other European (EU) nursing homes are still lacking. ⋯ The data demonstrate significant deficits in the recognition and treatment of pain in residents living in German or other European nursing home facilities. Further scope for improvement is seen in better recognition of relevant pain, in the adequate use of PRN and long-term medication and especially in the use of activating non-pharmacological treatment.
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Non-opioid analgesics are frequently used to control chronic pain in elderly patients; however some of these drugs show high rates of adverse drug reactions. Among these are significant clinical problems which impede an effective and safe pain control. ⋯ Acetaminophen, metamizol and flupirtin may be recommended instead; however a shortcoming of acetaminophen in comparison to NSAIDs is its weaker action to control pain. Metamizol is still banned in some countries due to rare but potentially severe hematological side effects and flupirtin frequently causes unfavorable sedation.
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Elderly patients with chronic pain are particularly at risk of functional limitations up to the loss of autonomy and social life. To facilitate autonomy, mobility and quality of life, physiotherapy plays an essential role in pain management. Nevertheless, programs that are specifically geared towards the needs of older patients are still uncommon. ⋯ First examples of pain management concepts for older adults demonstrate the positive results of activating therapy. Additionally, this article provides insights into barriers and resources of affected patients and all actors involved. However, physiotherapeutic treatment for aged chronic pain patients in Germany still shows considerable shortcomings but also offers an exciting challenge for the future.