Document Detail

Impact of revisions to the F-Tag 309 surveyors' interpretive guidelines on pain management among nursing home residents.
MedLine Citation:
PMID:  22462594     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: On 31 March 2009, the US Centers for Medicare & Medicaid Services (CMS) provided revised guidance for meeting compliance in the evaluation and management of pain in nursing home residents, known as F-Tag 309.
OBJECTIVE: The aim of the study was to estimate the extent to which implementation of revisions to the surveyors' interpretive guidelines for F-Tag 309 improved recognition and management of pain among nursing home residents.
METHODS: The impact of the revisions to guidance on F-Tag 309 on pain in nursing home residents was investigated. The study was quasi-experimental in design and included 174 for-profit nursing homes in 19 US states. Nursing home residents with ≥2 Minimum Data Set (MDS) assessments between 1 January 2007 and 30 March 2009 (before the revisions to the guidelines; n = 8449) and between 31 March 2009 and 31 December 2009 (after the revisions; n = 1400) were included. The MDS assessments provided information on pain, analgesic use and cognitive, functional and emotional status. Separate logistic regression models that adjusted for clustering effects of residents residing in nursing homes provided estimates of the relationship between the implementation of the revisions to F-Tag 309 and the prevalence of pain and its management.
RESULTS: Pain was more likely to be documented in the period after the revisions were implemented. The odds of pain being documented on at least one of two consecutive MDS assessments increased after the revisions to the guidelines were implemented (adjusted odds ratio [OR] 1.15; 95% confidence interval [CI] 1.01, 1.31). Increases in scheduled analgesic prescription were observed in the post-revision era (adjusted OR 1.38; 95% CI 1.21,1.57).
CONCLUSION: The implementation of revisions to the surveyors' interpretive guidelines for F-Tag 309 improved recognition and management of pain as well as analgesic use in nursing home residents with documented non-cancer pain. Use of directed language as part of the surveyors' interpretive guidelines may be a viable approach to stimulating improvements in pain documentation and management.
Kate L Lapane; Brian J Quilliam; Wing Chow; Myoung S Kim
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Drugs & aging     Volume:  29     ISSN:  1170-229X     ISO Abbreviation:  Drugs Aging     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-03     Completed Date:  2012-08-15     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  9102074     Medline TA:  Drugs Aging     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  385-93     Citation Subset:  IM    
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MeSH Terms
Analgesics / therapeutic use
Centers for Medicare and Medicaid Services (U.S.)
Cluster Analysis
Guideline Adherence
Logistic Models
Nursing Homes*
Pain / diagnosis,  drug therapy,  epidemiology
Pain Management / methods*
Practice Guidelines as Topic*
Quality Assurance, Health Care
United States
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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