Pain assessment in advanced dementia. Validity of the German PAINAD - A prospective double-blind randomised placebo-controlled trial

Lukas, A; Hagg-Grün, U; Mayer, B; Fischer, T; Schuler, M

Pain assessment in advanced dementia. Validity of the German PAINAD - A prospective double-blind randomised placebo-controlled trial

Lukas, A Hagg-Grün, U Mayer, B Fischer, T

Schuler, M

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Publication Type:: Journal Article
Citation:: Pain, 2019, 160 (3), pp. 742 - 753
Issue Date:: 2019-03-01

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Field	Value	Language
dc.contributor.author	Lukas, A	en_US
dc.contributor.author	Hagg-Grün, U	en_US
dc.contributor.author	Mayer, B	en_US
dc.contributor.author	Fischer, T https://orcid.org/0000-0003-3779-4396	en_US
dc.contributor.author	Schuler, M	en_US
dc.date.issued	2019-03-01	en_US
dc.identifier.citation	Pain, 2019, 160 (3), pp. 742 - 753	en_US
dc.identifier.issn	0304-3959	en_US
dc.identifier.uri	http://hdl.handle.net/10453/135646
dc.description.abstract	© 2018 International Association for the Study of Pain. Pain in combination with dementia is a common condition that makes pain recognition significantly more difficult. This results in undertreatment of pain in those suffering from dementia. The Pain Assessment in Advanced Dementia (PAINAD) scale currently represents one of the best approaches to pain detection in dementia. In a pilot study, strong inter-rater and retest reliability of the German version (PAINAD-G) was proven. However, the available data concerning the validity of this instrument were insufficient. The aim of the study was to validate the PAINAD-G scale by a double-blind randomised placebo-controlled trial in people with advanced dementia expected to be in pain. A second aim was to examine whether other observational tools (BISAD = Observation Instrument for Assessing Pain in the Elderly with Dementia) (German: Beobachtungsintrument für das Schmerzassessment bei alten Menschen mit Demenz, Checklist of Nonverbal Pain Indicators, Algoplus) were also able to demonstrate a significant difference between the study groups. Surprisingly, the study revealed no difference in "pain reduction" between those treated by oxycodone compared with those treated by placebo. Equally, none of the other 3 observational tools were able to demonstrate a significant difference between the study groups. However, correlations among the 4 observational tools were mostly moderate to high. A number of possible reasons for this observation, such as difficulties regarding sensitivity to change/responsiveness, consistence of the fundamental construct, influence of the early onset study, and efficacy of the analgesic in advanced dementia are discussed.	en_US
dc.relation.ispartof	Pain	en_US
dc.relation.isbasedon	10.1097/j.pain.0000000000001430	en_US
dc.subject.classification	Anesthesiology	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Dementia	en_US
dc.subject.mesh	Pain	en_US
dc.subject.mesh	Oxycodone	en_US
dc.subject.mesh	Analgesics, Opioid	en_US
dc.subject.mesh	Pain Measurement	en_US
dc.subject.mesh	Treatment Outcome	en_US
dc.subject.mesh	Prospective Studies	en_US
dc.subject.mesh	Double-Blind Method	en_US
dc.subject.mesh	Reproducibility of Results	en_US
dc.subject.mesh	Mental Status Schedule	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Germany	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.title	Pain assessment in advanced dementia. Validity of the German PAINAD - A prospective double-blind randomised placebo-controlled trial	en_US
dc.type	Journal Article
utslib.citation.volume	3	en_US
utslib.citation.volume	160	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	11 Medical and Health Sciences	en_US
utslib.for	17 Psychology and Cognitive Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access
pubs.issue	3	en_US
pubs.publication-status	Published	en_US
pubs.volume	160	en_US

Abstract:

© 2018 International Association for the Study of Pain. Pain in combination with dementia is a common condition that makes pain recognition significantly more difficult. This results in undertreatment of pain in those suffering from dementia. The Pain Assessment in Advanced Dementia (PAINAD) scale currently represents one of the best approaches to pain detection in dementia. In a pilot study, strong inter-rater and retest reliability of the German version (PAINAD-G) was proven. However, the available data concerning the validity of this instrument were insufficient. The aim of the study was to validate the PAINAD-G scale by a double-blind randomised placebo-controlled trial in people with advanced dementia expected to be in pain. A second aim was to examine whether other observational tools (BISAD = Observation Instrument for Assessing Pain in the Elderly with Dementia) (German: Beobachtungsintrument für das Schmerzassessment bei alten Menschen mit Demenz, Checklist of Nonverbal Pain Indicators, Algoplus) were also able to demonstrate a significant difference between the study groups. Surprisingly, the study revealed no difference in "pain reduction" between those treated by oxycodone compared with those treated by placebo. Equally, none of the other 3 observational tools were able to demonstrate a significant difference between the study groups. However, correlations among the 4 observational tools were mostly moderate to high. A number of possible reasons for this observation, such as difficulties regarding sensitivity to change/responsiveness, consistence of the fundamental construct, influence of the early onset study, and efficacy of the analgesic in advanced dementia are discussed.

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http://hdl.handle.net/10453/135646