Learning Objective 1: discuss the advantages of prescribing opioid analgesic over NSAIDs in the management of persistent pain in older adults.
Learning Objective 2: choose the best evidence in the pharmacological management of mild to moderate persistent pain in older adults.
Methods: This is a cross-sectional descriptive correlational study which included a convenience sample of 424 NPs attending a national NP conference. The study describes NPs knowledge and adherence to clinical guidelines on the pharmacological management of persistent pain in older adults. NPs knowledge and adherence were compared with recommendations from the AGS (2009) guideline titled Pharmacological Management of Persistent Pain in Older Persons. The instruments used in this study were a background data questionnaire and the Pharmacological Management of Persistent Pain in Older Adults Survey.
Results: The findings revealed NPs’ prescribing practices adhered to current recommendations to a greater extent than did having knowledge of specific recommendations. The majority of NP participants relied on NSAIDs/COX-2 and opioid analgesics equally. NPs with full prescriptive authority (M = 27.83, SD = 3.30) were more likely to adhere to guideline recommendations than those without controlled substances prescribing privileges (M = 26.84, SD = 3.49); t(408) = 2.40, p = .02. NPs who reported attending continuing education on the management of pain in older adults were more knowledgeable and adherent to the clinical practice guidelines.
Conclusion: NP participants’ knowledge and prescribing practices in the management of persistent pain in older adults and evidenced based practice guidelines may be narrowing. Tremendous opportunities exist in graduate nursing education to expand NPs’ competencies in the management and prescribing of analgesics in the treatment of persistent pain in older adults. As primary providers, NPs advocate for older adults who suffer from persistent pain and must ensure that they receive the best type of analgesic regardless of the author of the prescription.