NR 449 Week 3 Assignment_RUA_Multimodal Pain Management for Chronic Pain in Older Adults

Clinical Question Chronic pain can greatly affect the quality of life of older adults and is compounded by multiple negative outcomes associated with that experience. Chronic pain also results in more complicated forms of physical activity and social engagement. As such, the use of multimodal pain management, consisting of both pharmacological (medications) and non-pharmacological (non-drug) therapies, has been explored by our organization as a potential way to achieve better outcomes compared to using traditional pharmacological modes of treatment alone. As estimated by the National Institute on Aging (2022), nearly half of all older adults living in the community experience chronic pain; this pain has the potential to lead to serious problems such as depression, loss of functional ability, and increased need for healthcare support. Furthermore, the use of medication alone to manage chronic pain can also create several adverse effects, including drowsiness, constipation, an increased risk of falls, and addiction to medications. Existing literature supports the use of non-pharmacological methods, such as physical therapy, exercise and mindfulness-based approaches, in addition to cognitive and behavioral therapies, to promote the effective management of chronic pain while simultaneously supporting the ability of older adults to maintain functional independence and improve their overall quality of life. The use of a multimodal approach also provides older adults with a greater degree of control over their chronic pain and may play a significant role in supporting feelings of empowerment among older adults who are experiencing chronic pain. To find evidence relevant to my PICOT question, I used three databases recognized as authoritative sources for nursing/healthcare: CINAHL Complete, PubMed, and the Nursing & Allied Health Database through Chamberlain University Library. In creating search terms, I focused on the fundamental concepts addressed by my PICOT question, such as, “elderly chronic pain,” “multimodal pain management,” “nonpharmacologic pain interventions,” “combination therapy older adults' chronic pain," and "elderly pain management." In addition, I used Boolean connectors between keywords to narrow the search by combining keywords together. Some examples include "chronic pain AND elderly AND multimodal" and “older adults AND pain management AND nonpharmacologic.” Combining keywords helped to ensure that findings dealt with both drug and non-drug approaches to chronic pain management. Many results were produced from the first search of each database. By way of example, a search for the terms ‘multimodal and chronic pain in elderly adults’ through CINAHL produced ~ 420 articles and a search for ‘nonpharmacologic and pain management in older adults’ through PubMed returned an estimated 510 total results. Upon applying restriction limits (2019-2024 publication dates), only the primary research articles that underwent peer-review, published in English, used human subjects, and were aged 65 years and older approximately 22 articles from all databases remained for abstract review purposes. I limited my searches because when I did initial searches, there were many articles returned; therefore, I used several limitations to narrow my results down to the best and most current evidence I could find. The limitations I used to limit my searches were: publication date range of 2019-2024;