(HealthDay News) — The Improving Pain Relief in Elder Patients (I-PREP) quality improvement (QI) intervention improves pain management in older adults in the emergency department, according to a study published in the Journal of the American Geriatrics Society.

Teresita M. Hogan, MD, from the University of Chicago, and colleagues conducted a controlled pre/postintervention examination among patients aged 65 years and older with moderate-to-severe pain in an academic urban emergency department. A linked standardized education and continuous QI was conducted for multidisciplinary staff in an emergency department.

The researchers observed a 47.5% increase in the percentage of participants who had a final pain score of 4 or less out of 10. There was significant improvement in the median decrease in pain intensity, from 0.0 to 5.0 (P<.001), and a decrease in the median final pain score from 7.0 to 4.0 (P<.001). There was a 43.7% increase in the proportion of participants with any pain improvement (P<.001). A significant increase was seen in pain reassessments, from 51.9% to 82.5% (P<.001). There was a significant increase in the percentage of participants receiving analgesics, from 64.1% to 84.8% (P<.001). The odds of receiving analgesics and having a follow-up pain score documented were increased after the intervention (odds ratios, 3.1 and 4.7, respectively).

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“The I-PREP intervention substantially improved pain management in older adults in the emergency department with moderate-to-severe musculoskeletal or abdominal pain,” the authors write.


  1. Hogan TM, Howell MD, Cursio JF, et al. Improving pain relief in elder patients (I-PREP): An emergency department education and quality intervention. 2016; doi: 10.1111/jgs.14377.