干旱区生态环境知识资源中心(Arid): Pain treatment and functional improvement in home health care: Relationship with dementia

Arid

DOI	10.1111/jgs.17420
	Pain treatment and functional improvement in home health care: Relationship with dementia
	Wang, Jinjiao; Cato, Kenrick; Conwell, Yeates; Yu, Fang; Heffner, Kathi; Caprio, Thomas, V; Nathan, Kobi; Monroe, Todd B.; Muench, Ulrike; Li, Yue
通讯作者	Wang, JJ (corresponding author), Room 2w 121,255 Crittenden Blvd, Rochester, NY 14642 USA.
来源期刊	JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
ISSN	0002-8614
EISSN	1532-5415
出版年	2021
英文摘要	Background Pain management is important to post-acute functional recovery, yet older persons with Alzheimer's disease and related dementias (ADRD) are often undertreated for pain. The main objectives were (1) to examine the relationship between ADRD and analgesic use among Medicare home health care (HHC) recipients with daily interfering pain, and (2) to examine the impact of analgesic use on functional outcome in patients with and without ADRD. Methods We analyzed longitudinal data from the Outcome and Assessment Information Set, Medicare HHC claims, and HHC electronic medical records during a 60-day HHC episode. The sample included 6048 Medicare beneficiaries >= 65 years receiving care from an HHC agency in New York in 2019 who reported daily interfering pain. Analgesic use was assessed during HHC medication reconciliation and included any analgesic, non-opioid analgesic, and opioid. ADRD was identified from ICD-10 codes (HHC claims) and cognitive impairment symptoms (Outcome and Assessment Information Set [OASIS]). Functional outcome was measured as change in the composite Activity of Daily Living (ADL) limitation score in the HHC episode. Results ADRD was related to a lower likelihood of using any analgesic (odds ratio [OR] = 0.66, 95% confidence interval [CI]: 0.49, 0.90, p = 0.008) and opioids (OR = 0.54, 95% CI: 0.47, 0.62, p < 0.001), but not related to non-opioid analgesic use (OR = 0.94, 95% CI: 0.74, 1.18, p = 0.58). Stratified analyses showed that any analgesic use (beta = -0.43, 95% CI: -0.73, -0.13, p = 0.004) and non-opioid analgesic use (beta = -0.31, 95% CI: -0.56, -0.06, p = 0.016) were associated with greater ADL improvement in patients with ADRD, but not in patients without ADRD. Opioid use was not significantly related to ADL improvement regardless of ADRD status. Conclusions HHC patients with ADRD may be undertreated for pain, yet pain treatment is essential for functional improvement in HHC. HHC clinicians and policymakers should ensure adequate pain management for older persons with ADRD for improved functional outcomes.
英文关键词	Alzheimer's disease and related dementias dementia home health care Medicare beneficiaries pain management post-acute care
类型	Article
语种	英语
收录类别	SCI-E ; SSCI
WOS记录号	WOS:000686961500001
WOS关键词	QUALITY-OF-LIFE ; OLDER-ADULTS ; PEOPLE ; MANAGEMENT ; OSTEOARTHRITIS ; INTERFERENCE ; TRANSITIONS ; HOSPITALS ; RESIDENTS ; FACILITY
WOS类目	Geriatrics & Gerontology ; Gerontology
WOS研究方向	Geriatrics & Gerontology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/364043
作者单位	[Wang, Jinjiao; Heffner, Kathi] Univ Rochester, Elaine Hubbard Ctr Nursing Res Aging, Sch Nursing, Rochester, NY USA; [Cato, Kenrick] Columbia Univ, Sch Nursing, New York, NY USA; [Cato, Kenrick] Columbia Univ, Dept Emergency Med, Irving Med Ctr, New York, NY USA; [Conwell, Yeates; Heffner, Kathi] Univ Rochester, Dept Psychiat, Med Ctr, New York, NY USA; [Yu, Fang] Arizona State Univ, Edson Coll Nursing & Hlth Innovat, Phoenix, AZ USA; [Heffner, Kathi; Caprio, Thomas, V; Nathan, Kobi] Univ Rochester, Med Ctr, Dept Med, Div Geriatr & Aging, Rochester, NY 14642 USA; [Caprio, Thomas, V] Univ Rochester, UR Med Home Care, Med Ctr, New York, NY USA; [Caprio, Thomas, V] Univ Rochester, Finger Lakes Geriatr Educ Ctr, Med Ctr, New York, NY USA; [Nathan, Kobi] St John Fisher Coll, Wegmans Sch Pharm, Rochester, NY USA; [Monroe, Todd B.] Ohio State Univ, Coll Nursing, Columbus, OH 43210 USA; [Muench, Ulrike] Univ Calif San Francisco, Sch Nursing, San Francisco, CA 94143 USA; [Li, Yue] Univ Rochester, Dept Publ Hlth S...
推荐引用方式 GB/T 7714	Wang, Jinjiao,Cato, Kenrick,Conwell, Yeates,et al. Pain treatment and functional improvement in home health care: Relationship with dementia[J],2021.
APA	Wang, Jinjiao.,Cato, Kenrick.,Conwell, Yeates.,Yu, Fang.,Heffner, Kathi.,...&Li, Yue.(2021).Pain treatment and functional improvement in home health care: Relationship with dementia.JOURNAL OF THE AMERICAN GERIATRICS SOCIETY.
MLA	Wang, Jinjiao,et al."Pain treatment and functional improvement in home health care: Relationship with dementia".JOURNAL OF THE AMERICAN GERIATRICS SOCIETY (2021).