Clinicians' Challenges In Pain Assessment And Pain Management Practice In Patients With Heart Failure

• Published in: Journal of cardiac failure 2024-01, Vol.30 (1), p.289-289
• Main Authors: Kang, Youjeong, Choi, Yong
• Format: Article
• Language: English
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2023.10.408

Pain is a prevalent symptom among older adults (i.e., those over the age of 65), but it tends to be underreported in this population because many consider it a part of the natural physiologic decline of aging. Pain is also common in patients with heart failure (HF) who are at high risk for frequent hospitalizations. In particular, frequent hospitalizations among older adults with HF often occur due to less accurate symptom recognition and delays in responding to HF symptoms such as pain compared to younger adults. Despite increasing awareness of the prevalence of pain among HF patients, little is known about how pain is assessed and managed by clinicians, especially among those specialized in HF care. Describe clinicians’ challenges in pain assessment and pain management practice in older adult patients with HF. This is a qualitative secondary analysis study. The data were drawn from in-depth interviews conducted with 20 HF-specialized clinicians across the United States as part of the original qualitative study. We used Crabtree and Miller's editing organizing style and a hermeneutic editing approach, which focuses on understanding the meaning of the data in its context. The majority of participants had more than five years of clinical experience with HF patients. Nearly 60% of the participants expressed confidence in their ability to assess and manage pain in older adults with HF. However, the majority also reported challenges in pain assessment and pain management, such as underreporting of pain among older adult patients with HF compared to younger patients. In particular, older adults with HF tend not to mention pain unless they are specifically asked.: “I think older people do not express it as much as like younger do. I mean, they are not as willing to express it. Whereas I think the younger people are more apt to - you know, they are more in tune.” Some participants mentioned that pain management challenges related to a lack of specific pain management guidelines targeting older adult patients with HF.: “I do not use a typical strategy for pain management, except, well, I guess I do in what I tell them what not to do.”. Another challenge is that some older adult patients tend not to take pain medications. This study identified significant challenges in pain assessment and management faced by HF-specialized clinicians in older adults with HF. Although some of these challenges are similar to those encountered when treating pain in the general older a