ArticleJournal of pain and symptom management2018
Pain and Emergency Department Use in the Last Month of Life Among Older Adults With Dementia.
Article in Journal of pain and symptom management, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A Systematic Review Evaluating Pain Assessment Strategies for Patients With Dementia in the Emergency Department: The Geriatric ED Guidelines 2.0.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Pooled it
- Family Caregiver Challenges in Pain Management for Patients with Advanced Illnesses: A Systematic Review.Journal of palliative medicine · 2022Pooled it
- The Effect of the Care Ecosystem Collaborative Care Model on End-of-Life Outcomes for People With Dementia and Their Caregivers.The American journal of hospice & palliative care · 2026Trial
- Testing the Implementation of the PAIN-CPG-EIT: Protocol for a Randomized Clinical Trial.JMIR research protocols · 2026Article
- Preliminary Evidence Supporting Validity and Reliability of the Assessment for Appropriate Use of Opioids for Long-Term Care.The Senior care pharmacist · 2025Article
- Emergency Care for Persons Living with Dementia.Emergency medicine clinics of North America · 2025Review
- Emergency department use and responsiveness to the palliative care needs of patients with dementia at the end of life: A scoping review.Palliative & supportive care · 2025Article
- Emergency Medical Services Provider-Perceived Alzheimer's Disease and Related Dementias in the Prehospital Setting.The western journal of emergency medicine · 2025Article
- Optimal Emergency Department Care Practices for Persons Living With Dementia: A Scoping Review.Journal of the American Medical Directors Association · 2022Article
- Primary care contacts, continuity, identification of palliative care needs, and hospital use: a population-based cohort study in people dying with dementia.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Article
- Indicators of an Integrated Home Care Model Shaped by the Needs of Patients Discharged from the Emergency Department.International journal of integrated care · 2020Article
- Hospice Staff Perspectives on Caring for People with Dementia: A Multisite, Multistakeholder Study.Journal of palliative medicine · 2020Article
- Community-Based Palliative Care Consultations: Comparing Dementia to Nondementia Serious Illnesses.Journal of palliative medicine · 2020Article
- The challenge of pain identification, assessment, and management in people with dementia: a qualitative study.BJGP open · 2020Article
- Pilot testing implementation of the pain management clinical practice guideline in nursing homes.Geriatric nursing (New York, N.Y.)Article
- Integration of palliative care in the management of multiple chronic conditions: An expert consensus paper with policy implications.Nursing outlookArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
contextPain may be a potentially modifiable risk factor for expensive and burdensome emergency department (ED) visits near the end of life for older adults with dementia.
objectivesThe objective of this study was to assess the effect of pain and unmet need for pain management on ED visits in the last month of life in older adults with dementia.
methodsThis is a mortality follow-back study of older adults with dementia in the National Health and Aging Trends Study who died between 2012 and 2014, linked to Medicare claims.
resultsTwo hundred eighty-one National Health and Aging Trends Study decedents with dementia met criteria (mean age 86 years, 61% female, 81% white). Fifty-seven percent had at least one ED visit in the last month of life, and 46.5% had an ED visit that resulted in a hospital admission. Almost three out of four (73%) of decedents experienced pain in the last month of life, and 10% had an unmet need for pain management. After adjustment for age, gender, race, educational attainment, income, comorbidities, and impairment in activities of daily living, pain was not associated with increased ED use in the last month of life (adjusted incident rate ratio 0.87, 95% CI 0.64-1.17). However, decedents with unmet need for pain management had an almost 50% higher rate of ED visits in the last month of life than those without unmet needs (adjusted incident rate ratio 1.46, 95% CI 1.07-1.99).
conclusionAmong older adults with dementia, unmet need for pain management was associated with more frequent ED visits in the last month of life.
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