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New QI Intervention Aids Pain Management for Seniors in the ER

Findings in patients aged 65 years and older with moderate-to-severe pain in academic ER

headache pain

MONDAY, Nov. 7, 2016 (HealthDay News) -- The Improving Pain Relief in Elder Patients (I-PREP) quality improvement (QI) intervention improves pain management in older adults in the emergency department, according to a study published online Nov. 2 in the Journal of the American Geriatrics Society.

Teresita M. Hogan, M.D., from the University of Chicago, and colleagues conducted a controlled pre/postintervention examination among patients aged 65 years and older with moderate-to-severe pain in an academic urban emergency department. A linked standardized education and continuous QI was conducted for multidisciplinary staff in an emergency department.

The researchers observed a 47.5 percent increase in the percentage of participants who had a final pain score of 4 or less out of 10. There was significant improvement in the median decrease in pain intensity, from 0.0 to 5.0 (P < 0.001), and a decrease in the median final pain score from 7.0 to 4.0 (P < 0.001). There was a 43.7 percent increase in the proportion of participants with any pain improvement (P < 0.001). A significant increase was seen in pain reassessments, from 51.9 to 82.5 percent (P < 0.001). There was a significant increase in the percentage of participants receiving analgesics, from 64.1 to 84.8 percent (P < 0.001). The odds of receiving analgesics and having a follow-up pain score documented were increased after the intervention (odds ratios, 3.1 and 4.7, respectively).

"The I-PREP intervention substantially improved pain management in older adults in the emergency department with moderate-to-severe musculoskeletal or abdominal pain," the authors write.

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