Pain Management

Over the past few decades, pain management has garnished more clinical attention due to the consideration of pain as the fifth vital sign. However, recently the use of pain as the fifth vital sign has received negative press as the opioid crisis continues. Today, pain is widely regarded as equally important to the assessment of body temperature, blood pressure, heart rate and respiratory rate. In the last decade research on effective pain assessment and management strategies have significantly soared. But this increased focus on pain has not necessarily improved the management of pain in older adults. With advancing age come numerous physical illnesses that can lead to significant pain. In the literature, the terms “chronic pain” and “persistent pain” are often used interchangeably.

“Persistent pain” has become the preferred term because it is less likely to be associated with negative stereotypes that providers and older adults often connect with the “chronic pain” label. Persistent pain is a personal emotional and physical experience. The pain is an unpleasant, subjective, and multifaceted experience that ranges from mild discomfort to agony; the frequency may be periodic, persistent, or always present. Persistent pain continues beyond the anticipated healing time of acute pain caused by injury or disease and lasts for at least three months. Outcomes of interest in this proposal are to improve persistent pain assessment and management for older adults. A secondary outcome is to ensure that older adults with persistent pain are treated effectively based on the best evidence. There are significant gaps in provider understanding of the use of opioids for pharmacological management of moderate to severe persistent pain in older adults.