Improving Pain Assessment and Management in Nursing Home Residents with Dementia Using a Nurse-Led Support Program

What this Trial Is About

Pain is a frequent issue affecting 30% to 80% of older adults living with dementia in nursing homes, yet it is often not properly assessed or treated. Untreated or over-treated pain can worsen quality of life, function, sleep, and behavior. This trial evaluates a new approach called PAIN-CPG-EIT, which combines a Pain Management Clinical Practice Guideline with a theory-based method to improve pain assessment, diagnosis, and management among nursing home residents with dementia. The study also examines differences in pain treatment and outcomes by sexgender and race. The PAIN-CPG-EIT intervention involves a research nurse facilitator working with community champions and stakeholder teams for 12 months. This includes monthly stakeholder meetings, staff education on pain management, mentoring and motivating staff to address pain, and ongoing monitoring of pain outcomes. Twelve nursing home communities are randomized to receive either PAIN-CPG-EIT or Education Only, where staff receive the same educational component without the additional mentoring and monitoring. Participants include nursing home residents living with dementia and pain. Researchers will collect pain assessments at baseline, 4 months, and 12 months, along with monitoring pain management plans and opioid use. The study measures treatment fidelity and evaluates pain using tools like the Pain in Alzheimers Disease PAIN-AD scale. The trial aims to improve pain care, understand health disparities, and enhance equity among older adults with dementia. The study is expected to continue until the end of 2028.

Testing the Pain Clinical Practice Guideline