A two part paper published recently in Age & Ageing, the scientific journal of The British Geriatrics Society, reveals that pain profiling in older patients has the potential to improve quality of life, and help target resources to those most at risk of disability. The study also found that the use of new pain profiles, which took into account the impact of pain and its subjective nature, might enable better management of pain, and more accurate predictions of healthcare utilisation among older people.
The research, 'Understanding pain among older persons' examines pain profiles in older patients, and their ability to predict disability, quality of life and help manage healthcare resources. The study, which was conducted by the University of Limerick in Ireland, highlights the fact that pain is a widely recognised problem in older people, and a common reason for enduring long-term disability. The data for the study was gathered from 8,171 respondents, aged 50 and over, living in a community setting. 65% reported not often being troubled by pain. Of the 2,896 respondents often troubled by pain, four pain profiles were identified using questions such as 'does the pain make it difficult for you to do your usual activities?', 'do you have a number of pain sites?' and 'are you taking medication to control the pain?'.
Previous large population studies examining pain in older people have been limited to data related to frequency of pain, and/or the reported pain intensity. The study is unique in that it recognises that the impact of pain may vary considerably, and is a subjective experience. It also takes into consideration the degree to which pain affects a person's ability to participate in home or occupational activities, how widespread the pain is, as well as the use of analgesic medications. The study highlights the benefit of considering a greater range of variables in pain profiling to improve management, and reduce excessive medical investigations and treatment.
The study also finds that pain profiling can be used to predict health care utilisation by older people. Identifying people with multi-site pain, or those with single-site pain which affects daily activities and requires medication, could prove a significant independent predictor of the utilisation of GP care and hospital outpatient visits. Access to such data could prove to be of enormous benefit from a health planning perspective.
Kieran O'Sullivan Lecturer in Physiotherapy in the Department of Clinical Therapies at the University of Limerick, and one of the lead authors of the Age & Ageing paper, said:
"For too long we have treated pain as an entity in itself, instead of treating the person in pain. These papers illustrate that a range of demographic, health and psychological factors influence the impact of pain on a person. By better matching pain treatment to the specific needs of each person, quality of life might be enhanced significantly while simultaneously reducing healthcare costs."
Articles: Understanding pain among older persons: Part 1 - the development of novel pain profiles and their association with disability and quality of life, Kieran O'Sullivan, Norelee Kennedy, Helen Purtill and Ailish Hannigan, Age & Ageing, doi: 10.1093/ageing/afw131, published online 19 July 2016.
Understanding pain among older persons: Part 2 - the association between pain profiles and healthcare utilisation, Norelee Kennedy, Kieran O'Sullivan, Ailish Hannigan and Helen Purtill, Age & Ageing, doi: 10.1093/ageing/afw128, published online 19 July 2016.