Role of Non-pharmacological Intervention for Pain Management in Nursing Home Residents During COVID-19: A Systematic Review

Abstract

Pain experienced by nursing home residents (NHRs) is a significant concern, especially in patients with cognitive impairment. In this group, pain can be revealed through agitation, facial expressions, and altered movements. Palliative care, warm blankets, and peer-led pain management are some of the non-pharmacological management options. Our aim is to explore non-pharmacological interventions used for pain control during the COVID-19 pandemic. Google Scholar and PubMed were utilized to retrieve comprehensive non-pharmacologic pain management studies published between 2020 and 2021. Some targeted studies included randomized controlled, clustered, and clinical trials. The study targeted the general global NHR population. Keywords used: “Pain Management Program”, “nursing home”, “Pain management post-COVID-19”. Seven independent analysts reviewed the study. Eleven studies investigated non-pharmacological interventions in pain management. Five met the inclusion criteria. Two studies assessed peer-led pain management programs (PAPs). The first study found that PAPs improved pain knowledge and skills of peer volunteers in nursing homes. The second study revealed that PAP significantly improved pain self-efficacy, pain inference, and quality of life. Another study showed that visually appealing digital elements such as family photographs and natural sceneries relaxed older adults with chronic pain. Using warm blankets reduced pain and agitation in one study. An improvement in pain and severity complaints, and analgesic use requests was noted. One study revealed the insignificance of palliative care residents’ comfort in the last week of life comparing intervention and control groups. Pain is a symptom often under-reported in nursing homes. Current evidence indicates the potential role of non-pharmacological interventions, mainly utilizing appealing digital devices, warm blankets, and PAP programs. This review found that non-pharmacological interventions increase awareness about pain and increase NHRs’ quality of life during COVID19 pandemic. Further studies are needed to assess effectiveness of non-pharmacological interventions as pain management tools.