Independent evaluation of PainChek in Australian aged care facilities reports positive clinical outcomes

In 2019, the Australian Department of Health provided a $5M grant to support the national roll-out of PainChek®.

To date, 40% of the total industry has signed up to use PainChek®’s pain assessment technology, including providers in regional and metropolitan areas — and PainChek® is now the most common clinical software in the residential aged care industry.

An independent review has been conducted to evaluate the efficacy of PainChek to improve the diagnosis and management of pain, quality of life, and/or health outcomes in people living with dementia in residential aged care. The findings were highly positive, with the national trial resulting in significant progress being made within the sector.

Facility implementation of PainChek®

An independent review of how PainChek® assessments have helped to better identify and manage residents’ pain since 2019 found:

    • Over 400,000 pain assessments have been conducted
    • 385 Residential Aged Care Providers managing 993 aged care facilities have been given
      access to PainChek
    • Almost 7,000 staff have registered to use PainChek and 4,400 staff have been trained to
      use the tool
    • Over 50,000 dementia licences for residents living with dementia and cognitive impairment have
      been activated

“The independent review showed overwhelmingly positive feedback from users. One example is an aged care resident who was experiencing chest pains resulting in challenging behaviour. After using PainChek®, staff were able to effectively manage her pain and the resident became much less stressed and agitated.”

— Philip Daffas, PainChek® CEO and Managing Director

National trial of PainChek® has resulted in a positive shift in aged care

The evaluation found that prior to the implementation of PainChek®, the aged care industry suffered from capability gaps in understanding pain assessment for residents experiencing dementia and cognitive impairment. Clinicians can at times struggle to differentiate dementia behaviours from underlying pain behaviours, which in turn can result in the unnecessary use of last-resort medications to manage behavioural symptoms.

Following the implementation of PainChek®, facilities reported greater awareness and capability toidentify pain behaviours associated with dementia through extensive staff training. Furthermore, pain assessment has become more prominent, regular, and more multi-disciplinary (involving Pharmacists, GPs, physios, DBMAS consultants). There have also been multiple cases where facilities have limited or corrected medication as a result of accurate pain assessment, which in turn has resulted in positive related outcomes.

The evaluation also found that previously, pain assessment was also seldom done at the point-of-care alongside the resident. Rather, assessments were typically completed back at the nurse’s station, often in bulk and from memory. There was also a level of resistance when using technology for clinical assessments, as many facilities lacked technology or connectivity. Overall, pain assessment in aged care was fragmented with various scales, tools, and reporting platforms.

For many providers, implementing PainChek® kickstarted a journey in delivering point-of-care assessments, and carers have become more comfortable using mobile devices to conduct clinical care. PainChek® has also integrated with all 9 major Care Management System (CMS) providers to remove duplication of effort and streamline clinical data. Earlier this year, the Numerical Rating Scale (NRS) has also been incorporated into the new PainChek® Universal solution — resulting in a complete point-of-care tool that enables best-practice pain management in all residents, including those who can self-report, those who cannot, and those who fluctuate between the two.

Case study: PainChek® was shown to instigate a reduction in the use of psychotropic medication through identifying pain as a cause of challenging behaviour.

A resident arrived to the facility following a hospital admission as a result of an injury. The resident exhibited agitated and aggressive behaviour, whereby facility staff felt that the resident was a risk to other residents.

The resident did not have a pain management program upon arrival to the facility. Due to the behaviours shown, a PainChek® assessment was undertaken. The assessment highlighted that the resident was experiencing severe pain.

Staff discussed this finding with the resident’s GP who initially increased the resident’s psychotropic medication dose, as well as prescribing some analgesia. This resulted in the resident becoming extremely drowsy. The GP subsequently removed the analgesia, however, this resulted in the resident’s agitated behaviours returning. The GP then removed the psychotropic medication and focused on managing the resident’s pain. Staff reported that the resident was a “different person”, with a severe reduction in agitation.

Case study: PainChek® has prompted a renewed focus on assessing pain across aged care facilities.

A resident had a long history of complaining of generalised pain, accompanied by challenging behaviour. Historically staff had believed the pain to be psychosomatic and no treatment was provided to address or manage the resident’s concerns. Following the implementation of PainChek® and a renewed focus on pain assessment and management, a PainChek® assessment was undertaken which showed moderate levels of pain. Staff responded by providing PRN analgesia which was effective in managing the resident’s pain and behaviour, with staff reporting that the resident was much less stressed and agitated.

Case study: Non-medication related interventions have been initiated to manage pain in response to PainChek® assessments.

Staff at a RACF report the objectivity of PainChek® as a useful means to better assess and quantify resident’s pain levels. For example, it was reported that a resident with severe dementia had a PainChek® assessment carried out which showed low levels of pain. Instead of using PRN medications to manage the resident’s pain, which often cause the resident to be drowsy, staff used a heat pack. It was reported that this was effective and more beneficial to the resident’s quality of life given this approach did not cause drowsiness. This experience has prompted a revised treatment pathway for this resident, whereby if the resident shows signs of agitated behaviour, staff assess for pain using PainChek® in order to quantify pain levels and therefore use the most appropriate intervention.

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