Table 3.

Nationally Representative Estimates of Pain Assessment, Management, and Pain Control Outcomes Among Older Patients Receiving Hospice Care

Variables	Unweighted N (Numerator/Denominator)	Weighted %
Pain assessment
First assessment of pain conducteda	3826/3918	97.1
Valid pain scale used at first assessmentb	2766/3826	68.9
Last assessment of pain conducteda	3659/3918	92.8
Valid pain scale used at last assessmentc	2018/3659	53.8
Pain management
Standing order for pain medication onlyb,d	301/3818e	8.8
PRN (as needed) order for pain medication onlyb,d	1096/3818e	29.3
Standing order and PRN order for pain medicationb,d	2218/3818e	56.4
Any nonpharmacologic strategy to manage painb,d	1720/3818e	42.0
Use of opioid analgesicsb,f	3207/3826	85.2
Use of nonopioid analgesicsb,f	2165/3826	58.4
Pain control outcomes
No reported pain at first assessmentg	1777/3026	63.7
No reported pain at last assessmentg	2126/3026	71.0
Pain improvement/maintenance of effective pain controlh	1068/1520	70.1

^aHospice discharges of patients 65 years or older.

^bHospice discharges of patients 65 years or older with first assessment of pain conducted.

^cHospice discharges of patients 65 years or older with last assessment of pain conducted.

^dBased on responses to the National Home Health and Hospice Care Survey Patient Health Module by designated hospice staff.

^eThe denominator for pain management strategies based on the questionnaire (3818) is lower than the total number of discharges with a first assessment (3826) because of missing responses to these questions.

^fBased on medication data collected from hospice medical records reflecting medications taken during the last eight days before hospice discharge.

^gHospice discharges of patients 65 years or older with both first and last assessments.

^hHospice discharges of patients 65 years or older for which pain assessment tools used for both first and last assessments were one of the following: 0–10 numeric, 0–10 face, 0–5 numeric, 0–5 face and verbal categories containing none, mild, moderate, and severe. Patients with no pain at first assessment were included only if they received some pain management during their hospice care.