Evaluating pain management in older people after orthopaedic surgery - a study in Jordan

Pain management in older people presents unique challenges due to age-related physiological changes, altered responses to medicines, comorbidities and polypharmacy. These challenges, which are exacerbated in those aged ≥75 years, can compromise the efficacy and safety of pharmacological treatment, including after discharge following orthopaedic surgery.

To evaluate pain management and follow-up care provided in primary care settings in Jordan to older people who had undergone orthopaedic surgery.

For this descriptive study, data were collected from the discharge summaries and electronic health records of older people who were receiving support from community nurses in rural primary care units in the Aqaba Governorate in Jordan after undergoing orthopaedic procedures in hospital.

Of the 100 participants, 63 lived in a nursing home and 30 had been diagnosed with dementia. Hip fractures, diagnosed in 56 participants, were the most common reason for surgery. Thirty-two participants had a documented post-discharge follow-up plan regarding pain management in primary care. Of the 90 participants who were still being followed up 12 weeks after discharge, 51 (57%) were still being prescribed opioids for regular use or as required.

Nurses have a crucial role in ensuring effective and safe pain management in older people, particularly when using opioids, due to the heightened risk of adverse effects and medicine interactions. Tailored pain management involves careful initiation of medicines; regular monitoring and assessment of pain levels, adherence to medicines and monitoring of potential side effects; and individualised follow-up plans.