Identification of an EBP Question
Elderly people are more susceptible to conventional pain control methods. They have more co morbidities and are more sensitive to narcotics. Narcotics even small doses can leave the elderly confused or unstable on their feet. This increases their risk of getting hurt from falls or the decrease in inhibitions related to narcotic use. When caring for elderly patients health care practitioners should use narcotics with great caution. Pharmaceutical interventions tend to have greater side effects. These side effects can be life threatening. There is also the risk of drug interactions with elderly patient’s daily medication regiments they take for their chronic conditions. The quest for safer pain control in the elderly is something every healthcare provider should be looking into.
Foreground Questions
- Is the use of alternative interventions to manage pain on elderly patients a better choice than the use of pharmaceutical drugs?
- Do elderly patients understand the benefits of using alternative interventions to manage pain?
- Do elderly patients in nursing homes benefit holistically from the use of alternative interventions to manage pain?
Problem Statement
Elderly patients are more likely to experience adverse events when their pain is treated with narcotics and other pharmaceutical products. They usually have at least 2 co morbidities and are at a greater risk for increased confusion and fall related to narcotic use. The population of adults aged 85 years and above is envisaged to rise from 5.3 million in 2006 to an estimated 26 million by the year 2050 (Cavalieri, 2007, p. 23-31) (Bruckenthal, 2010). This rapidly growing population poses significant complexities in the management of chronic pain among elderly patients owing to its high prevalence among this population segment (Kemp, Ersek, & Turner, 2005). Research statistics indicate that over 116 million of the United States’ adult population suffers from chronic pain (Keefe, Porter, Somers, Shelby, & Wren, 2013). Elderly patients tend to have an increased sensitivity to narcotics which necessitates the need to find alternative methods to control their pain. Pharmaceuticals also pose a greater risk of harmful drug interactions due to medications they take for chronic conditions.
In this backdrop, there is an increased need to explore alternative interventions in the management of persistent pain among elderly persons. More important, the use of alternative interventions is instrumental in addressing the inherent challenges of conventional pain management. While the knowledge of alternative interventions in chronic pain management remains low, elderly patients aware of complementary and alternative interventions are motivated to use non-pharmaceutical medication owing to its ability to relieve pain, enhance the quality of life, and improve individuals’ health and fitness (Williamson, Fletcher, & Dawson, 2003).
References
Bruckenthal, P. (2010). Integrating nonpharmacologic and alternative strategies into a comprehensive management approach for older adults with pain. Pain Management Nursing, 11(2), 23-31. doi:10.1016/j.pmn.2010.03.004
Cavalieri, T. A. (2007). Managing Pain in Geriatric Patients []. The Journal of the American Osteopathic Association, 107, ES10-ES16. Retrieved from http://jaoa.org/article.aspx?articleid=2093506
Cheng, S., Chan, K. L., Lam, R. W., Mok, M. H., Chen, P. P., Chow, Y. F., … Tam, C. W. (2017, May 5, 2017). A Multicomponent Intervention for the Management of Chronic Pain in Older Adults: Study Protocol for a randomized Controlled Trial []. Trials, 18(528). https://doi.org/10.1156/s13063-017-2270-3
Gatchel, R. J., Hulla, R., Vanzzini, N., Silas, E., Bevers, K., & Garner, T. (2017). Pain Management and the Elderly []. Practical Pain Management, 17(1). Retrieved from https://www.practicalpainmanagement.com/treatments/pain-management-elderly
Keefe, F. J., Porter, L., Somers, T., Shelby, R., & Wren, A. V. (2013, July 1, 2013). Psychosocial Interventions for Managing Pain in Older Adults: Outcomes and Clinical Implications []. British Journal of Anaesthesia, 111(1), 89-94. https://doi.org/10.1093/bja/aet129
Kemp, C. A., Ersek, M., & Turner, J. A. (2005). A Descriptive Study of Older Adults with Persistent Pain: Use and Percieved Effectiveness of Pain Management Strategies []. BMC Geriatrics, 5(12). https://doi.org/10.1186/1471-2318-5-12
Lewis, M. J., Kohtz, C., Emmerling, S., Fisher, M., & McGarvey, J. (2018, September). Pain Control and Nonpharmacologic Interventions []. Nursing 2018, 48(9), 65-68. https://doi.org/10.1097/01.NURSE.0000544231.59222.ab
Markesich, D., Workman, T., Heggeness, M., & Fordis, M. (2011). Pain Management Interventions forElderly Patients with Hip Fractures []. Agency for Healthcare Research and Quality:Advancing Excellance in Health Care. Retrieved from https://effectivehealthcare.ahrq.gov/topics/hip-fracture-pain/clinician/
Niknejad, B., Bolier, R., & Henderson, C. R. (2018). Association Between Psychological Interventions and Chronic Pain Outcomes in Older Adults: A Systemis Review and Meta-Analysis []. JAMA Internal Med., 178(6), 830-839. https://doi.org/10.1001/jamainternmed.2018.0756
Simmons, S. F., Schnello, J. F., Saraf, A. A., Coelho, C. S., Jacobsen, M. J., Kripalani, S., … Vasilevskis, E. E. (2015). July 16, 2015 []. The Gerontologist, 56(6). https://doi.org/10.1093/geront/gnv058
Williamson, A. T., Fletcher, P., & Dawson, K. A. (2003). Complementary and alternative medicine: Use in an older population. Journal of Gerontological Nursing, 29(5), 20-28.
Zwakhalen, S. M., Hamers, J. P., Peijnenburg, R. H., & Berger, M. P. (2007). Nursing Staff Knowledge and Beliefs about Pain in Elderly Nursing Home Residents with Dementia []. Pain Research and Management, 12(3), 177-184. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670708
