Williams Brie A, Ahalt Cyrus, Stijacic-Cenzer Irena, Smith Alexander K, Goldenson Joe, Ritchie Christine S
1 Division of Geriatrics, University of California , San Francisco, San Francisco, California.
J Palliat Med. 2014 Dec;17(12):1336-43. doi: 10.1089/jpm.2014.0160.
The number of older jail inmates in poor health is increasing rapidly. Among older adults, pain is common and leads to greater acute care use. In jail, pain management is complicated by concerns about misuse and diversion. A lack of data about the prevalence and management of pain in older jail inmates limits our ability to develop optimal palliative care strategies for this population.
To describe the prevalence of and factors associated with pain and analgesic use in a population of older jail inmates.
Cross-sectional study. χ(2) tests assessed association between characteristics, pain, and analgesic use.
SETTING/SUBJECTS: Two hundred ten jail inmates age 55 or older.
"Severe frequent pain" defined as "severe or very severe" pain experienced "frequently or constantly" using the validated Memorial Symptom Assessment Scale. Medical conditions, substance use, and analgesic treatment determined through self-report and jail medical records.
Participants' mean age was 59 years; 69% had multimorbidity; 75% reported any pain; 39% reported severe frequent pain. Report of severe frequent pain was associated with multimorbidity, functional impairment, and pre-jail acute care use (p<0.05), but not with substance use (57% versus 56%, p=0.89). Within a week of their interview, most participants with severe frequent pain had received an analgesic (87%) and many received an opioid (70%).
High rates of pain in a rapidly growing population of older jail inmates with multimorbidity and functional impairment suggest that jails are an important site for assessing symptom burden and developing appropriate palliative care interventions.
健康状况不佳的老年监狱囚犯数量正在迅速增加。在老年人中，疼痛很常见，且会导致更多的急性护理使用。在监狱中，疼痛管理因对药物滥用和转移的担忧而变得复杂。缺乏关于老年监狱囚犯疼痛患病率和管理的数据限制了我们为该人群制定最佳姑息治疗策略的能力。
描述老年监狱囚犯人群中疼痛及镇痛药物使用的患病率和相关因素。
横断面研究。χ²检验评估特征、疼痛和镇痛药物使用之间的关联。
地点/研究对象：210名年龄在55岁及以上的监狱囚犯。
使用经过验证的纪念症状评估量表，将“严重频繁疼痛”定义为“频繁或持续”经历的“严重或非常严重”的疼痛。通过自我报告和监狱医疗记录确定医疗状况、物质使用情况和镇痛治疗情况。
参与者的平均年龄为59岁；69%患有多种疾病；75%报告有任何疼痛；39%报告有严重频繁疼痛。严重频繁疼痛的报告与多种疾病、功能障碍和入狱前的急性护理使用相关（p<0.05），但与物质使用无关（57%对56%，p=0.89）。在访谈的一周内，大多数有严重频繁疼痛的参与者接受了镇痛药（87%），许多人接受了阿片类药物（70%）。
在患有多种疾病和功能障碍的老年监狱囚犯迅速增长的人群中，疼痛发生率很高，这表明监狱是评估症状负担和制定适当姑息治疗干预措施的重要场所。
