PHARMACOEPIDEMIOLOGY AND PRESCRIPTION
Prevalence of pain and pharmacological pain treatment among old
people in nursing homes in 2007 and 2013
Received: 14 August 2017 / Accepted: 26 November 2017 / Published online: 20 December 2017
The Author(s) 2017. This article is an open access publication
Purpose Many elderly people living in nursing homes experience pain and take analgesic medication. The aim of this study was
to analyze the prevalence of pain and pharmacological pain treatment among people living in nursing homes in Sweden, in two
large, comparable, samples from 2007 to 2013.
Methods Cross-sectional surveys were performed in 2007 and 2013, including all residents in nursing homes in the county of
Västerbotten, Sweden. A total of 4933 residents (2814 and 2119 respectively) with a mean age of 84.6 and 85.0 years partici-
pated. Of these, 71.1 and 72.4% respectively were cognitively impaired. The survey was completed by the staff members who
knew the residents best.
Results The prescription of opioids became significantly more common while the use of tramadol decreased significantly. The
staff reported that 63.4% in 2007 and 62.3% in 2013 had experienced pain. Of those in pain, 20.2% in 2007 and 16.8% in 2013
received no treatment and 73.4 and 75.0% respectively of those with pain, but no pharmacological treatment, were incorrectly
described by the staff as being treated for pain.
Conclusions There has been a change in the pharmacological analgesic treatment between 2007 and 2013 with less prescribing of
tramadol and a greater proportion taking opioids. Nevertheless, undertreatment of pain still occurs and in many cases, staff
members believed that the residents were prescribed analgesic treatment when this was not the case.
With rising age, there is an increased risk of contracting chron-
ic and life-limiting, painful medical conditions . The most
common pain sites in older people are the back, leg/knee or
hip, and other joints . Pain has been associated with re-
duced physical and psychological functioning [3, 4]andin
interviews, half of the elderly patients admitted for palliative
care ranked elimination of pain as their primary need .
In people with dementia, pain is common and frequently
under-treated , and adequate pain evaluation and treatment
in people with dementia has been shown to have positive
effects . For example, several studies have shown that pain
treatment might reduce behavioral and psychological symp-
toms of dementia [8, 9].
* Maria Gustafsson
Department of Community Medicine and Rehabilitation, Geriatric
Medicine, Umeå University, SE-901 87 Umeå, Sweden
Department of Pharmacology and Clinical Neuroscience, Division of
Clinical Pharmacology, Umeå University, SE-901 87 Umeå, Sweden
Department of Nursing, Umeå University, SE-901 87 Umeå, Sweden
Arctic Research Centre at Umeå University, SE-901
87 Umeå, Sweden
Department of Neurobiology, Care Sciences and Society, Division of
Nursing, Karolinska Institutet, SE-171 77 Stockholm, Sweden
Department of Health Sciences, University of Technology,
European Journal of Clinical Pharmacology (2018) 74:483–488