Please use this identifier to cite or link to this item:
Appears in Collections:Faculty of Social Sciences Journal Articles
Peer Review Status: Refereed
Title: Expert opinion on the management of pain in hospitalised older patients with cognitive impairment: A mixed methods analysis of a national survey
Author(s): Rodger, Kirsty T M
Greasley-Adams, Corinne
Hodge, Zoe
Reynish, Emma
Contact Email:
Keywords: Pain
Cognitive impairment
Issue Date: 29-Apr-2015
Date Deposited: 14-May-2015
Citation: Rodger KTM, Greasley-Adams C, Hodge Z & Reynish E (2015) Expert opinion on the management of pain in hospitalised older patients with cognitive impairment: A mixed methods analysis of a national survey. BMC Geriatrics, 15, Art. No.: 56.
Abstract: Background: Hospitalised older patients are complex. Comorbidity and polypharmacy complicate frailty. Significant numbers have dementia and/or cognitive impairment. Pain is highly prevalent. The evidence base for pain management in cognitively impaired individuals is sparse due to methodological issues. A wealth of expert opinion is recognised potentially providing a useful evidence base for guiding clinical practice. The study aimed to gather expert opinion on pain management in cognitively impaired hospitalised older people. Methods: Consultant Geriatricians listed as dementia leads in the National Dementia Audit were contacted electronically and invited to respond. The questionnaire sought information on their role, confidence and approach to pain management in cognitively impaired hospitalised patients. Responses were analysed using a mixed methods approach. Results: Respondents considered themselves very confident in the clinical field. Awareness of potential to do harm was highly evident. Unequivocally responses suggested paracetamol is safe and should be first choice analgesic, newer opiates should be used preferentially in renal impairment and nefopam is unsafe. A grading of the safety profile of specific medications became apparent, prompting requirement for further evaluation and holistic assessment. Conclusion: The lack of consensus reached highlights the complexity of this clinical field. The use of paracetamol first line, newer opiates in renal impairment and avoidance of nefopam are immediately transferrable to clinical practice. Further review, evaluation and comparison of the risks associated with other specific analgesics are necessary before a comprehensive clinical guideline can be produced.
DOI Link: 10.1186/s12877-015-0056-6
Rights: © 2015 Rodger et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
Licence URL(s):

Files in This Item:
File Description SizeFormat 
Rodger et al_BMC Geriatrics_2015.pdfFulltext - Published Version552.57 kBAdobe PDFView/Open

This item is protected by original copyright

A file in this item is licensed under a Creative Commons License Creative Commons

Items in the Repository are protected by copyright, with all rights reserved, unless otherwise indicated.

The metadata of the records in the Repository are available under the CC0 public domain dedication: No Rights Reserved

If you believe that any material held in STORRE infringes copyright, please contact providing details and we will remove the Work from public display in STORRE and investigate your claim.