@article{5c0a57d8eb2f4a1e9112367b2386b54c,
title = "A mixed-methods study on the pharmacological management of pain in Australian and Japanese nursing homes",
abstract = "Background: Understanding how analgesics are used in different countries can inform initiatives to improve the pharmacological management of pain in nursing homes. Aims: To compare patterns of analgesic use among Australian and Japanese nursing home residents; and explore Australian and Japanese healthcare professionals{\textquoteright} perspectives on analgesic use. Methods: Part one involved a cross-sectional comparison among residents from 12 nursing homes in South Australia (N = 550) in 2019 and four nursing homes in Tokyo (N = 333) in 2020. Part two involved three focus groups with Australian and Japanese healthcare professionals (N = 16) in 2023. Qualitative data were deductively content analysed using the World Health Organization six-step Guide to Good Prescribing. Results: Australian and Japanese residents were similar in age (median: 89 vs 87) and sex (female: 73% vs 73%). Overall, 74% of Australian and 11% of Japanese residents used regular oral acetaminophen, non-steroidal anti-inflammatory drugs or opioids. Australian and Japanese healthcare professionals described individualising pain management and the first-line use of acetaminophen. Australian participants described their therapeutic goal was to alleviate pain and reported analgesics were often prescribed on a regular basis. Japanese participants described their therapeutic goal was to minimise impacts of pain on daily activities and reported analgesics were often prescribed for short-term durations, corresponding to episodes of pain. Japanese participants described regulations that limit opioid use for non-cancer pain in nursing homes. Conclusion: Analgesic use is more prevalent in Australian than Japanese nursing homes. Differences in therapeutic goals, culture, analgesic regulations and treatment durations may contribute to this apparent difference.",
keywords = "Analgesics, Nursing homes, Older people, Pain, Pain management, Qualitative research, Residential aged care homes",
author = "Dowd, {Laura A.} and Shota Hamada and Yukari Hattori and Veal, {Felicity C.} and Reina Taguchi and Nobuo Sakata and Jadczak, {Agathe D.} and Renuka Visvanathan and Eriko Koujiya and Madhu Rajan and Stefan Doube and Ai Suzuki and Maree Bernoth and Helen Rawson and Hiroshi Maruoka and Amelia Wood and Jo Wagner and Hull, {Dee Anne} and Mizuki Katsuhisa and Justin Turner and Liau, {Shin J.} and Emily Reeve and Bell, {J. Simon} and Cross, {Amanda J.}",
note = "Funding Information: The Frailty in Residential Sector over Time (FIRST) Study and ADJ were funded through project funding to RV from the Healthy Ageing Research Consortium funded by the South Australian Department for Innovation and Skills, Hospital Research Foundation and Resthaven Inc (Australia, part 1). Japanese data collection (Japan, part 1) was supported by the JSPS KAKENHI (grant number 22 K10406). The funding source had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication. LAD and SJL were supported by postgraduate research scholarships funded by Monash University. SJL, RV and JSB were supported by the NHMRC Centre of Research Excellence in Frailty and Healthy Ageing. ER was supported by an NHMRC Investigator Grant (APP1195460). All other authors have no finding to declare. SJL was supported by the Australian Government Research Training Program Scholarship. JSB was supported by the NHMRC Boosting Dementia Research Leadership Fellowship. AJC was supported by a National Health and Medical Research Council (NHMRC) Emerging Leadership Fellowship. Funding Information: The authors would like to acknowledge Terry Short for supporting the FIRST study coordination and contributing to the study design, as well as Hilary Ashby who supported the FIRST study coordination. They would also like to thank their study nurses Jean Zhang, Victoria Foy and Kim Testi who conducted the data collection and collected informed consent. The authors would like to acknowledge Tina Cooper and Leonie Robson for contributing to the FIRST study design, and thank Tina Cooper and Merridy Baylis for reviewing this manuscript. Funding Information: SH belongs to an endowed chair funded by donations from Hakue technology, PROUMED, Japan Bio Products, Towa Pharmaceutical, Yellow Eight and Sugi Holdings. RV was previously a board member and a member of the clinical governance committee of Resthaven Inc. Recently, she received honorarium for participation in workgroups from HealthConsult Pty Ltd in relation to a Commonwealth Funded project. In the past, she has received honoraria, speakers and educational grants in various combinations from Nutricia, Abbott and Nestl{\'e}. She is a founding member to a technology start up, HealthyVibes.ai. ER has received royalties for co-authoring a chapter on deprescribing in UpToDate and honorarium from the Society of Hospital Pharmacists of Australia (leading workshops on deprescribing). AJC has received grant or consulting funds from the Medical Research Future Fund and the Pharmaceutical Society of Australia. All these funds were paid to the administering University. AJC is also a national board director for the Pharmaceutical Society of Australia. JSB has received grant or consulting funds from the NHMRC, Medical Research Future Fund, Victorian Government Department of Health and Human Services, Dementia Australia Research Foundation, Yulgilbar Foundation, Aged Care Quality and Safety Commission, Australian Commission on Safety and Quality in Health Care, Dementia Centre for Research Collaboration, Pharmaceutical Society of Australia, Society of Hospital Pharmacists of Australia, GlaxoSmithKline Supported Studies Programme, Amgen, and several aged care provider organisations. All these funds were paid to the administering University. All other authors have no conflicts of interest to declare. Publisher Copyright: {\textcopyright} The Author(s) 2024.",
year = "2024",
month = feb,
doi = "10.1093/ageing/afae024",
language = "English",
volume = "53",
journal = "Age and Ageing",
issn = "0002-0729",
publisher = "Oxford University Press",
number = "2",
}
