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August 15, 2001

Persistent Pain in Nursing Home Residents—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor

JAMA. 2001;286(7):788. doi:10.1001/jama.286.7.788

In Reply: Mr Brown questions the validity of the findings of a high prevalence of pain in nursing home residents in light of the December 2000 report of the Office of the Inspector General that calls for improvement in the process of completion of the MDS. Our study relies on universally available administrative data describing nursing home residents' pain. We agree that, to the extent that these data are more reliable and incorporated into the care planning process (the original intention of the MDS), the value of the data will also improve.1 As we noted, we believe that our findings underestimate the true rate of pain. Engle et al2 confirmed this in a recent report, finding that, although health care providers' assessments of pain are reasonably reliable among themselves, they systematically underestimate the frequency and intensity of pain in the MDS when compared with patients' perspectives. Furthermore, our results are consistent with previous research, including interviews with family members3 and expert pain assessment.4

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