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Non-pharmacological interventions for pain in people with dementia: A systematic review

Authors: Liao Yo-Jen, Parajuli Jyotsana, Jao Ying-Ling, Kitko Lisa, Berish DianeJournal: International journal of nursing studiesPublished: December 1, 2021DOI: 10.1016/j.ijnurstu.2021.104082
Q1 JournalSJR: 2.1h-index: 148SCImago
Strong EvidenceSystematic Review

In Plain Language

Pain commonly occurs in people living with dementia but is often undertreated. Non-pharmacological interventions are a safer first-line option for pain management, but evidence-based interventions for people living with dementia have not been established. An increasing number of studies have examined the effect of non-pharmacological interventions in pain management. However, the evidence that specifically focuses on people living with dementia has not been systematically reviewed. This review aimed to systematically synthesize current evidence on non-pharmacological interventions to manage pain in people living with dementia. A comprehensive search of the literature was conducted in PubMed, CINAHL, Scopus, and Web of Science databases. Studies were included if they were 1) peer-reviewed original quantitative research, 2) tested the effect of non-pharmacological interventions on pain in people with dementia, and 3) English language. Studies were excluded if they 1) included both pharmacological and non-pharmacological interventions and did not report separate results for the non-pharmacological interventions; 2) enrolled participants with and without dementia and did not have separate results reported for individuals with dementia; 3) tested dietary supplements as the intervention; and 4) were not original research, such as reviews, editorials, commentaries, or case studies. Title, abstract, and full text were screened. Quality assessment was conducted using the Cochrane Risk of Bias tool and Johns Hopkins Level of Evidence. Pain assessment tools, participant characteristics, study designs, intervention condition, and results were extracted. Results were synthesized through grouping the type of the interventions and weighting evidence based on quality and design of the studies. A total of 11 articles and 12 interventions were identified. A total of 486 participants were included. Interventions that have shown a positive impact on pain include ear acupressure, mus

Key Findings: what this systematic review found

  • ✓Pain is commonly undertreated in people living with dementia despite being a frequent occurrence.
  • ✓Non-pharmacological interventions are recommended as safer first-line options for pain management in dementia patients compared to pharmacological approaches.
  • ✓Evidence-based non-pharmacological interventions specifically designed for pain management in people living with dementia have not yet been systematically established.

What This Means for You

If you have dementia or care for someone who does, non-drug pain treatments may help, but the research is still developing and you should discuss options with your healthcare team.

What This Means for Practitioners

This systematic review identifies non-pharmacological pain management evidence for dementia patients, which can inform your practice, though you should review the full findings to see which interventions showed the strongest support.

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Common questions about this study

What does this study mean in practice?

If you have dementia or care for someone who does, non-drug pain treatments may help, but the research is still developing and you should discuss options with your healthcare team.

What did this study find?

Pain is commonly undertreated in people living with dementia despite being a frequent occurrence. Non-pharmacological interventions are recommended as safer first-line options for pain management in dementia patients compared to pharmacological approaches. Evidence-based non-pharmacological interventions specifically designed for pain management in people living with dementia have not yet been systematically established.

How strong is this evidence?

This is a systematic review and we rate its evidence strong. It was published in International journal of nursing studies, a Q1 journal. This study is indexed here for context; it did not test reflexology itself.

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