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Analgesic use, pain and daytime sedation in people with and without dementia in aged care facilities: a cross-sectional, multisite, epidemiological study protocol
  1. Edwin C K Tan1,
  2. Renuka Visvanathan2,3,
  3. Sarah N Hilmer4,5,
  4. Agnes I Vitry6,
  5. Tara Quirke7,
  6. Tina Emery8,
  7. Leonie Robson8,
  8. Terry Shortt8,
  9. Simon Sheldrick8,
  10. Sunny (Soon Won) Lee8,
  11. Robyn Clothier3,8,
  12. Emily Reeve4,5,
  13. Danijela Gnjidic4,9,
  14. Jenni Ilomäki1,
  15. J Simon Bell1,5,6,10
  1. 1Faculty of Pharmacy and Pharmaceutical Sciences, Centre for Medicine Use and Safety, Monash University, Melbourne, Australia
  2. 2Discipline of Medicine, University of Adelaide, Adelaide, Australia
  3. 3Aged and Extended Care Services, The Queen Elizabeth Hospital and Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, School of Medicine, University of Adelaide, Adelaide, Australia
  4. 4Departments of Clinical Pharmacology and Aged Care, Kolling Institute of Medical Research, Sydney Medical School, Royal North Shore Hospital, The University of Sydney, Sydney, Australia
  5. 5Cognitive Decline Partnership Centre, Hornsby Ku-ring-gai Hospital, Hornsby, Australia
  6. 6Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
  7. 7Consumer Dementia Research Network, Alzheimer's Australia, Scullin, Australia
  8. 8Resthaven Limited, Adelaide, South Australia
  9. 9Faculty of Pharmacy, University of Sydney, Sydney, Australia
  10. 10Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland
  1. Correspondence to Professor J Simon Bell; simon.bell2{at}


Introduction People living with dementia may experience and express pain in different ways to people without dementia. People with dementia are typically prescribed fewer analgesics than people without dementia indicating a potential difference in how pain is identified and treated in these populations. The objectives of this study are to (1) investigate the prevalence of analgesic load, pain and daytime sedation in people with and without dementia in Australian residential aged care facilities (RACFs), and (2) investigate the clinical and diagnostic associations between analgesic load, pain and daytime sedation in people with and without dementia in Australian RACFs.

Methods/analysis This will be a cross-sectional study of 300 permanent residents of up to 10 low-level and high-level RACFs in South Australia with and without dementia. Trained study nurses will administer validated and dementia-specific assessments of self-reported and clinician-observed pain, sedation and other clinical and humanistic outcomes. Medicine-use data will be extracted directly from each resident's medication administration chart. Binary and multinominal logistic regression will be used to compute unadjusted and adjusted ORs and 95% CIs for factors associated with pain, analgesic load and daytime sedation. These factors will include dementia severity, behavioural and psychological symptoms, quality of life, resident satisfaction, attitudes towards medicines, activities of daily living and nutritional status.

Ethics and dissemination Institutional ethics approval has been granted. The findings will be disseminated through public lectures, professional and scientific conferences and in peer-reviewed journal articles. The findings of this study will allow for a better understanding of the prevalence and factors associated with analgesic use, pain and other outcomes in residential care. The findings of this study will be used to inform the development and implementation of strategies to improve the quality of life of people with dementia.

  • Epidemiology
  • Geriatric Medicine
  • Pain Management

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