Towards improved decision support in the assessment and management of pain for people with dementia in hospital: systematic meta-review and observational study
Award Number
11/2000/05Programme
Health and Social Care Delivery ResearchStatus / Stage
CompletedDates
2 October 2012 -1 October 2015
Duration (calculated)
02 years 11 monthsFunder(s)
NIHRFunding Amount
£755,993.76Funder/Grant study page
NIHRContracted Centre
University of LeedsPrincipal Investigator
Professor José ClossPI ORCID
0000-0002-3257-5277WHO Catergories
Tools and methodologies for interventionsDisease Type
Dementia (Unspecified)CPEC Review Info
| Reference ID | 126 |
|---|---|
| Researcher | Reside Team |
| Published | 12/06/2023 |
Data
| Award Number | 11/2000/05 |
|---|---|
| Status / Stage | Completed |
| Start Date | 20121002 |
| End Date | 20151001 |
| Duration (calculated) | 02 years 11 months |
| Funder/Grant study page | NIHR |
| Contracted Centre | University of Leeds |
| Funding Amount | £755,993.76 |
Abstract
In 2007 the National Audit Office reported that 60% of hospital beds are occupied by older people, of whom 40% may have dementia. To date, there have been no studies in the United Kingdom exploring how pain is detected and managed in people with dementia on acute hospital wards. This study will address the following research questions: 1. How are clinicians detecting, managing and documenting pain in people with dementia in acute care settings? 2. What is the clinical utility of existing tools to assist with the detection and management of pain in people with dementia in acute care settings? 3. How acceptable and feasible would it be to introduce decision support tools into acute care settings? 4. What is the role of carers in supporting the detection of pain in people with dementia in acute care settings? The MRC framework for the development and evaluation of complex interventions has been used to guide the study design. The study has three components: 1. Two linked systematic reviews of existing evidence. The first will be a synthesis of existing systematic reviews of pain tools used with individuals with cognitive impairment. The second will be a review of pain assessment strategies used in acute care settings for use with people with dementia. 2. A multiple case site study with embedded units of analysis (individual, ward, organisation). We will collect multiple sources of evidence including observation of practice, interviews with clinical staff, carers and managers, and audits of policies and procedures to provide an in-depth analysis of current pain detection and management practices. This phase will explore how carers are currently included in the process, and identify areas where it could be improved. 3. Development of decision support tools and assessment of their acceptability in practice. On the basis of the findings from 1 and 2 decision support tools will be developed and iteratively evaluated in two stages. Focus groups will be used to refine tool development, before they are implemented in hospital wards. Acceptability and feasibility will be assessed using observation of tool use, interviews and documentary audit. We will include carers in the design and evaluation of the tools in this phase. The study will provide valuable insights into the challenges faced by clinical staff when assessing and managing pain in patients with dementia. It will produce decision support tools that have been initially tested for acceptability in acute care settings and guidance for carers and clinicians to support implementation of the research.
Aims
Through carrying out this study we aim to improve the care that patients with dementia receive when they are admitted to hospital, by ensuring that their pain is effectively managed.