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Related Experiment Video

Updated: May 19, 2026

Determining Pain Detection and Tolerance Thresholds Using an Integrated, Multi-Modal Pain Task Battery
09:38

Determining Pain Detection and Tolerance Thresholds Using an Integrated, Multi-Modal Pain Task Battery

Published on: April 14, 2016

Addressing methodological challenges in implementing the nursing home pain management algorithm randomized controlled

Mary Ersek1, Nayak Polissar, Anna Du Pen

  • 1Philadelphia Veterans Affairs Medical Center, Philadelphia, PA 19104-6096, USA. ersekm@nursing.upenn.edu

Clinical Trials (London, England)
|August 11, 2012
PubMed
Summary
This summary is machine-generated.

Implementing pain management algorithms with comprehensive adoption programs in nursing homes improved care. Challenges included measuring outcomes in cognitively impaired residents, highlighting the need for adaptable research strategies.

Related Experiment Videos

Last Updated: May 19, 2026

Determining Pain Detection and Tolerance Thresholds Using an Integrated, Multi-Modal Pain Task Battery
09:38

Determining Pain Detection and Tolerance Thresholds Using an Integrated, Multi-Modal Pain Task Battery

Published on: April 14, 2016

Area of Science:

  • Gerontology
  • Nursing Home Care
  • Pain Management

Background:

  • Unrelieved pain is a significant issue in nursing home (NH) residents.
  • Evidence-based clinical guidelines exist but require intensive implementation strategies for practice change.
  • Integrating guidelines into protocols and algorithms can enhance clinical decision-making.

Purpose of the Study:

  • To compare the effectiveness of pain management algorithms plus a comprehensive adoption program against education alone.
  • To assess improvements in pain assessment and management, reduction in pain and depressive symptoms, and enhanced mobility in NH residents.

Main Methods:

  • Cluster-randomized controlled trial (RCT) with NHs as the unit of randomization.
  • Intervention framework based on Roger's Diffusion of Innovations theory.
  • Outcome measures included surrogate-reported pain, self-reported pain (usual/worst), pain interference, depression, and mobility.

Main Results:

  • Study included 485 NH residents from 27 NHs using staggered enrollment.
  • Adaptive randomization successfully balanced intervention and control sites.
  • Strategies were implemented to enhance algorithm adoption, but outcome measurement in cognitively impaired residents posed challenges.

Conclusions:

  • Methodological challenges are inherent in conducting RCTs.
  • Optimizing internal validity can be compromised by logistical issues during study conduct.
  • The study faced difficulties in identifying universally applicable outcome measures for all NH residents.