# Testing the Pain-CPG-EIT

> **NIH NIH R01** · UNIVERSITY OF MARYLAND BALTIMORE · 2024 · $426,168

## Abstract

Pain is experienced by 30% to 80% of residents living with dementia in nursing homes. For those with
moderate to severe dementia verbal reporting of pain may not be reliable and observational approaches are
recommended as pain in these individuals is more likely to present with facial expressions or behaviors such
as aggression, agitation, or restlessness. Lack of accurate pain assessment results in untreated or over-
treated pain. Untreated pain can lower quality of life, negatively impact function, impair sleep, increase
depression, agitation, aggression, resistiveness to care and use of psychotropic medications. Further, the
evaluation, management and treatment of pain are complicated by differences in pain sensitivity, verbal
reporting or presentation of pain between genders, races and ethnicities. Although inconsistent, in some
studies individuals living with dementia who were Black were more likely to have depression and sleep
disturbances associated with pain and less likely to be treated for pain when compared to White residents.
There are evidence based processes for assessment and management of pain using pharmacologic and
nonpharmacological approaches. These were reviewed and included within the Pain Management Clinical
Practice Guideline (Pain Management CPG) recently developed by AMDA: The Society for Post-Acute and
Long-Term Care Medicine. There are, however, many challenges to translating the use of Clinical Practice
Guidelines into clinical settings. To overcome these challenges we developed and previously tested a
theoretically based approach and merged this approach with the Pain Management CPG, which is referred to
as the PAIN-CPG-EIT. The PAIN-CPG-EIT involves a research nurse facilitator working with an identified
community champion(s) and stakeholder team for 12 months to provide the following four components:
Component I: Establishing and meeting monthly with a Stakeholder Team; Component II: Education of the
staff; Component III: Mentoring and motivating the staff to address pain; Component IV: Ongoing evaluation of
resident pain outcomes. Twelve communities will be included with 25 residents living with dementia and pain
recruited from each community. Six communities will be randomized to treatment (PAIN-CPG-EIT) and six
randomized to education only (EO) which involves providing the same education to staff as is done in
Component II of PAIN-CPG-EIT. The primary aim of this study is to test the effectiveness of use of the PAIN-
CPG-EIT to improve the assessment, diagnosis and management of pain and decrease pain intensity among
nursing home residents living with dementia between baseline, 4 and 12 months and evaluate treatment
fidelity. A secondary aim of the study is to consider differences in measurement, treatment and response to
treatment between male and female and Black versus White residents living with dementia. Findings from this
study will help build on the currently limited information about pain presentation an...

## Key facts

- **NIH application ID:** 10917251
- **Project number:** 5R01AG082676-02
- **Recipient organization:** UNIVERSITY OF MARYLAND BALTIMORE
- **Principal Investigator:** BARBARA RESNICK
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $426,168
- **Award type:** 5
- **Project period:** 2023-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10917251

## Citation

> US National Institutes of Health, RePORTER application 10917251, Testing the Pain-CPG-EIT (5R01AG082676-02). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10917251. Licensed CC0.

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