21 Apr Minimise the effects of chronic pain on the immune system during COVID-19
With the recent rise in COVID-19 cases across Australia, including in aged care facilities, many are wondering how to best protect residents during this time. Older people are among the most at-risk for COVID-19, and it’s essential to take every precaution to ensure their bodies are able to fight off disease.
New measures such as social distancing are essential to stave off infections and protect both residents and carers. However, effective pain management still remains essential for residential aged care facilities during these times, particularly as chronic pain may potentially lead to negative effects on the immune system.
How can chronic pain affect the immune system?
According to Pain Australia, over 80% of aged care residents experience chronic pain. In addition, more than 85% of people with dementia suffer pain at any time, and 50% experience pain on a persistent basis. Unfortunately pain often goes under-detected and under-treated in this vulnerable population, particularly amongst those with advanced dementia, due to a reduced ability to self-report pain. This poses a number of issues with respect to infection risk.
Firstly, there have been some studies showing a link between chronic pain and a suppressed immune system, although this relationship is complex and scientific research remains limited. Secondly, the conditions which are the source of the pain may contribute to infection risk (for example, diabetes), and the American Society of Regional Anesthesia and Pain Medicine (ASRA) has reported that the medications used to treat chronic pain may do the same (e.g. non-steroidal anti-inflammatory drugs, corticosteroids, opioids, immunosuppressive agents).
Given this link between some pain medications and a suppressed immune system, optimal pain control is essential to ensure patients are getting the minimum effective dose, while ensuring the risk of disease doesn’t outweigh the benefit.
On top of this, when pain goes unrecognised, pain behaviours may be misdiagnosed as behavioural and psychological symptoms of dementia (BPSD) and lead to the inappropriate use of antipsychotics and sedative agents. Multiple studies have demonstrated a link between the use of these agents and an increased risk of pneumonia.
In the study ‘Antipsychotic use in elderly patients and the risk of pneumonia’, research found that the risk of pneumonia increases two- to three-fold for elderly patients on antipsychotics (dependent on dose) when compared to nonuse. In particular, elderly populations over 65 who are treated with antipsychotics may have an increased risk of pneumonia when compared to their younger counterparts.
Similar results have been found when patients are treated with sedatives. A study conducted by a group of European scientists found that the use of benzodiazepines in community-dwelling adults with Alzhiemers led to an increased risk of pneumonia.
Eccleston and others in their paper on managing patients with chronic pain during the COVID-19 outbreak state that “…populations with higher existing pain burden are more likely to experience higher incidence of COVID-19 infections, greater disruption to their usual healthcare access, and worse downstream consequences of abruptly altered health care. This speaks to the need to optimise pain management amongst residents of aged care facilities, who according to the Centres for Disease Control and Prevention (CDC), are at a higher risk of severe illness from COVID-19 because of their age (generally 65 years and older), and the fact they live in a nursing home or long-term care facility.
PainChek supports COVID-19 chronic pain best practice guidelines
During these challenging times, pain management is essential to reduce the burden of pain on aged care residents, as well as the risk of infection. To assist aged care facilities in better navigating the challenges presented by chronic pain during COVID-19, ASRA has recently released a list of best practice guidelines for effective pain management.
- Risk mitigation by limiting unnecessary visits and strict sterile techniques in line with infection control measures.|
- The use of technology to enable remote training, delivery and monitoring, as well as distance point of care pain assessment.
- Special considerations for residents with dementia, including monitoring the impact of isolation measures and the impact of staff wearing PPEs on residents’ behaviours.
- Monitoring for medication-induced problems in residents, such as psychotropics, delirium and worsening of behaviours.
PainChek supports residential aged care facilities in adopting COVID-19 chronic pain best practice guidelines by helping carers better assess and manage pain in residents, while complying with infection control measures.
Many tools that are used to assess pain are subjective and manual, making it difficult for carers to accurately gauge pain levels and prescribe the correct treatments to manage residents’ pain. However, PainChek® provides an accurate means of pain assessment using facial recognition and analysis together with smart automation to detect and quantify pain and communicate results in real time. This tool. in the form of a point-of-care App. has been proven in clinical studies to be a valid, reliable and accurate means of assessing pain in people who cannot verbalise their pain, which offers significant advantages over other currently available pain assessment methods.
At the same time, PainChek® provides carers with a solution for assessing pain safely while reducing the risk of viral transmission. PainChek®’s automated facial analysis can be completed from up to 3 metres from the resident, allowing carers to assess residents’ pain at a distance. The assessment takes less than 3 minutes to complete and is all done digitally—limiting interaction time between residents and carers, and reducing the risk of person-to-person transmission. Finally, assessment data is stored digitally and accessible in real-time, allowing carers to monitor the ongoing effects of medication and treatment over time.
Free 12-month subscription of PainChek available for all residential aged care facilities in Australia
If you are an Australian residential aged care facility looking to improve pain assessment and management in our facility, you are eligible for a free 12-month subscription of PainChek.
The grant is part of a Federal Government Department of Health initiative to promote innovation in Aged Care and support improved care and pain assessment for those living with Dementia or other cognitive impairments. To date, PainChek has been used in over 50,000 licensed beds across Australia —29,000 of which have been funded through the Government-subsidised roll-out.
As a software-as-a-service technology, PainChek® is fully deployed in the cloud and supported by a comprehensive digital program. As such, residential aged care facilities can benefit from the initiative, and implement the program without delays or restrictions.
Remote training and onboarding can be conducted any time, anywhere. New clients can download the App remotely via the Google Play or Apple App Store, and access a robust online training platform to learn how to use the tool to accurately assess pain.
To register your interest for the initiative, fill out this form now. This initiative is available for a limited time only, so sign up today to avoid missing out.
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