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Dowd LA, Hamada S, Hattori Y, Veal FC, Taguchi R, Sakata N, Jadczak AD, Visvanathan R, Koujiya E, Rajan M, Doube S, Suzuki A, Bernoth M, Rawson H, Maruoka H, Wood A, Wagner J, Hull DA, Katsuhisa M, Turner J, Liau SJ, Reeve E, Bell JS, Cross AJ. A mixed-methods study on the pharmacological management of pain in Australian and Japanese nursing homes. Age Ageing 2024; 53:afae024. [PMID: 38411410 PMCID: PMC10898334 DOI: 10.1093/ageing/afae024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/12/2023] [Indexed: 02/28/2024] Open
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' 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.
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Affiliation(s)
- Laura A Dowd
- Centre for Medicine Use and Safety (CMUS), Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Shota Hamada
- Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo, Japan
- Department of Home Care Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yukari Hattori
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Felicity C Veal
- Unit for Medication Outcomes Research & Education (UMORE), School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Tasmania, Australia
| | - Reina Taguchi
- Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo, Japan
| | - Nobuo Sakata
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
- Heisei Medical Welfare Group Research Institute, Tokyo, Japan
| | - Agathe D Jadczak
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Frailty and Healthy Ageing, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Renuka Visvanathan
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Frailty and Healthy Ageing, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Eriko Koujiya
- Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Madhu Rajan
- Royal Australian College of General Practitioners, Victoria, Australia
- Aged Care GP, Melbourne, Victoria, Australia
| | | | - Ai Suzuki
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Maree Bernoth
- Charles Sturt University, Wagga Wagga, New South Wales, Australia
- Three Rivers Department of Rural Health, Wagga Wagga, New South Wales, Australia
- Murrumbidgee Primary Health Network Aged Care Consortium, Wagga Wagga, New South Wales, Australia
| | - Helen Rawson
- Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Hiroshi Maruoka
- Yokohama Aobanosato Geriatric Health Services Facility, Yokohama, Japan
| | - Amelia Wood
- Longridge Aged Care, Naracoorte, South Australia, Australia
| | - Jo Wagner
- Australian Nursing and Midwifery Federation (SA Branch), Adelaide, South Australia, Australia
| | - Dee-Anne Hull
- Southern Cross Care (SA, NT and VIC), Glenside, South Australia, Australia
| | - Mizuki Katsuhisa
- Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Justin Turner
- Centre for Medicine Use and Safety (CMUS), Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
- Centre de Recherche, Institue Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
- Faculté de Pharmacie, Université Laval, Québec city, Québec, Canada
| | - Shin J Liau
- Centre for Medicine Use and Safety (CMUS), Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Frailty and Healthy Ageing, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Emily Reeve
- Centre for Medicine Use and Safety (CMUS), Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
- Quality Use of Medicines and Pharmacy Research Centre, University of South Australia: Clinical and Health Sciences, Adelaide, South Australia, Australia
| | - J Simon Bell
- Centre for Medicine Use and Safety (CMUS), Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Frailty and Healthy Ageing, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Amanda J Cross
- Centre for Medicine Use and Safety (CMUS), Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
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