Norwegian Study: Pain Assessment and Management Key in Helping Alzheimer’s Patients

by Wendy Williams, BSN, M.Ed., Associate Director of the Pain Research, Education and Policy Program (PREP),  Tufts University School of Medicine

The evidence continues to mount that proactive pain management makes a difference in lives (in this case, for both the identified patient and the staff and families that care for them in nursing homes).

A research article was published in the British Medical Journal on July 17th and concludes the following: “A systematic approach to the management of pain significantly reduced agitation in residents of nursing homes with moderate to severe dementia. Effective management of pain can play an important part in the treatment of agitation and could reduce the number of unnecessary prescriptions for psychotropic drugs in this population.”

You can listen to a BBC journalist interviewing one of the authors here.   This problem has been outlined before; the challenge of good pain assessment in the non-verbal.  In particular, a 2006 Web-MD article reviews a study done in Australia by Leonie J. Cole and colleagues entitledPain a Problem in Alzheimer’s Disease: Undertreated Pain Plagues Alzheimer’s Patients Who Hurt, but Can’t Tell.

Have you heard of any good studies recently?  We need to keep promoting evidence based practice and advocacy for people with undertreated pain…. Hope to hear from you on any news you might have on this front.

Add comment July 18th, 2011

10 Year Milestone for PREP Program at Tufts

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By Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP student and PREP-AIRED blog moderator
The Pain Research, Education and Policy Program at Tufts University has reached an important milestone by celebrating its first ten years of existence. In the Fall of 1999, the first two students were welcomed into the new master’s program, the first of its kind in the United States, founded by two prominent pain specialists, Daniel Carr, MD, an anthesthesiologist-internist, and sociologist Kathryn Lasch, PhD; and housed within the Tufts University School of Medicine. Recent MS-PREP alumna, Xu Cheng, discovered an archive edition of the Tufts Daily announcing the MS-PREP program’s launch on October 26, 1999.
Click here to view the Tufts Daily 1999 article
In 2009, the PREP program remains an innovative, multidisciplinary program that has grown and evolved since its launch a decade ago. As one of the foremost experts in the field of pain management, Dr. Daniel Carr continues to be a guiding presence in the growth and direction of the Pain Research Education and Policy program. On the occasion of the 10 year anniversary of the program, I asked Dr. Carr to share his reflections about the PREP program with the PREP-AIRED blog community. Dr. Carr’s remarks appear in the italicized text below:
“Ten years ago, a front page article in the Tufts Daily announced the launch of a new Masters of Science degree program in Pain Research, Education and Policy (“MSPREP”). Kathryn Lasch PhD, a medical sociologist now with an international outcomes research consultancy, and I were its co-founders. The inaugural class had 2 students. Shahnaz Turkistani, a physician, returned to her native Saudi Arabia after graduation and now treats women with pain. Ewan McNicol, a Tufts-based pharmacist now on the PREP faculty, is known internationally for systematic reviews of pain therapies with the Cochrane Collaboration and others.
The first of its kind in the United States, our program remains unique and has grown slowly and steadily since 1999. We now offer a shorter, certificate track in addition to the original MS track. We owe much to the Sackler family, whose initial and ongoing support has been indispensable, the Hermanson family for funding scholarships, and the Saltonstall family for supporting pain research in the Department of Anesthesia at Tufts Medical Center, the source of many PREP faculty. Jeanne Connolly-Horrigan combined a marketing background and passion for pain control to help us grow enrollment during the mid-2000s. Richard Glickman-Simon MD, now its Director, brought a career-long interest in complementary and alternative medicine and built a successful dual degree program between PREP and the New England School of Acupuncture.
Our faculty have taught students, treated patients, advised policymakers and professional organizations, and authored many articles and books. Our next book is a guide to pain treatment for busy clinicians practicing in the current era of health care reform. The editors of this volume are Ewan McNicol MSPREP, Carol Curtiss MSN RN BC, a distinguished nurse educator and PREP faculty member, and me; other contributors include Richard Glickman-Simon MD, Libby Bradshaw DO, MS, PREP’s Associate Director, and Steven Scrivani DDS PhD, another valued faculty member. We 6 faculty comprise PREP’s Steering Committee. Given pain’s burden upon public health, it is most appropriate that PREP is housed within the Department of Public Health and Community Medicine, capably led by Dean Harris Berman and more recently, Dean Aviva Must.
For me, the best thing about the first 10 years of PREP has been seeing our students succeed as they extend and enhance their careers, helping those with pain and becoming educational resources for their new colleagues. Students have come to PREP from across the US and from many countries, with diverse healthcare and non-healthcare backgrounds, and from other graduate programs at Tufts and affiliates. They have been MDs, RNs, DDSs, pharmacists, PTs, OTs, EMTs and others interested in pain, whether making a mid-career change from another field or beginning their graduate training immediately after college. One is the principal pain nurse educator in a large urban medical center. Another works with a world-famous outcomes research consultancy, on pain. Yet another accepted a high-profile advocacy position at a major pharmaceutical company. Another works in a hospice. Others have proceeded to medical or osteopathic school or to seek a PhD.
Our students are a very special group of altruistic people. We are proud of all they have achieved. We look forward to serving more and more students as society at large and the health professions increasingly understand how fundamentally important pain control is for quality of life, and accept pain control as a basic human right.”

Thank you to Dr. Carr and the PREP faculty for their vision and passion in the field of pain control, may the PREP program continue to blaze the trail for many years to come.

2 comments October 29th, 2009

Declaration of Health Data Rights

by Lisa Neal Gualtieri, PhD, Adjunct Clinical Professor, Tufts University School of Medicine
We just celebrated Independence Day and can easily see how, in the US, we have rights that we often take for granted until we compare our lives with those of people in other countries. However what are the rights of patients? Loosely modeled after the Declaration of Independence, is a new Declaration of Health Data Rights which states:
In an era when technology allows personal health information to be more easily stored, updated, accessed and exchanged, the following rights should be self-evident and inalienable. We the people:
1. Have the right to our own health data
2. Have the right to know the source of each health data element
3. Have the right to take possession of a complete copy of our individual health data, without delay, at minimal or no cost; if data exist in computable form, they must be made available in that form
4. Have the right to share our health data with others as we see fit
These principles express basic human rights as well as essential elements of health care that is participatory, appropriate and in the interests of each patient. No law or policy should abridge these rights.
This was created by patient advocates, caregivers, health care professionals, technology and policy experts, and entrepreneurs. It is both controversial and timely given government initiatives and the wealth of technology available, as well as recently announced initiatives, such as Beth Israel Deaconess Medical Center’s,pilot program to allow patients to see notes written about them by their doctors.
What do you think about the Declaration of Health Data Rights and the potential impact?

Add comment July 7th, 2009


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