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American Journal of Hospice and Palliative Medicine®
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Evaluation of a Behavioral Assessment Tool for the Individual Unable to Self-report Pain

Rob W. Hutchison, PharmD

Presbyterian Hospital of Dallas, 8200 Walnut Hill Lane, Pharmacy Department, Dallas, TX 75231; robhutchison{at}texashealth.org

William F. Tucker, Jr, MD

Sunghyun Kim, PharmD

Richard Gilder, RN, BSN, CNOR, BCNI

Assessment of pain intensity using a standard self-reported pain score is standard practice in most institutions. These instruments require the cognitive ability to process the pain intensity into a numeric or descriptive value. Many institutions are considering adopting an assessment tool for cognitive impairment. The purpose of this study is to evaluate a clinician-administered assessment tool, PAINAD, in patients with cognitive impairment. Opioid consumption and frequency of documented unknown pain were collected in 2 cognitive impaired groups. In the control group, a self-reporting pain intensity tool was used, and in a second group, the PAINAD was used. Opioid use was significantly higher (P = .003) and the rates of reported unknown pain were significantly lower (P < .01) in the group using the PAINAD instrument compared to the control group of patients with cognitive impairment. There were no noted differences in opioid-induced adverse reactions in either group.

Key Words: assessment tool • acute pain • dementia • PAINAD

American Journal of Hospice and Palliative Medicine®, Vol. 23, No. 4, 328-331 (2006)
DOI: 10.1177/1049909106290244
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