Quality and appropriateness of pain medication. Instrument for estimation in nursing home residents

BACKGROUND: The pain medication appropriateness scale (PMASD) was developed in 2006 in the USA to evaluate the quality and appropriateness of pain treatment in nursing home residents (NHR). This tool can be used to identify potential problems with the pharmacological treatment of pain. METHODS: We developed a German version (PMASD) adapted to the German setting and applied it in Germany to NHR with and without cognitive impairment for the first time. In agreement with the original instrument a test result of >67 % was considered as appropriate pain treatment. RESULTS: For the 560 analyzed NHR the average SPMAS score was 39±1,7 (range from -67 to +100). Overall 72% of the study population did not achieve the defined threshold for appropriate pain management. CONCLUSIONS: An appropriate tool for quantitative evaluation of pain treatment was so far not available in Germany. The PMASD analysis showed deficits of pain management in NHR. This tool showed good practicability in Germany and could provide a valuable tool for pain treatment in clinical research and practice.