{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:02:25Z","timestamp":1791468145207,"version":"4.3.4"},"reference-count":51,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2014,5,13]],"date-time":"2014-05-13T00:00:00Z","timestamp":1399939200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"funder":[{"DOI":"10.13039\/501100005416","name":"Norwegian Research Council","doi-asserted-by":"crossref","award":["protocol code 189439"],"award-info":[{"award-number":["protocol code 189439"]}],"id":[{"id":"10.13039\/501100005416","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2014,11]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Pain is frequent and distressing in people with dementia, but no randomized controlled trials have evaluated the effect of analgesic treatment on pain intensity as a key outcome.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Three hundred fifty\u2010two people with dementia and significant agitation from 60 nursing home units were included in this study. These units, representing 18 nursing homes in western\n N<\/jats:styled-content>\n orway, were randomized to a stepwise protocol of treating pain (\n SPTP<\/jats:styled-content>\n ) or usual care. The\n SPTP<\/jats:styled-content>\n group received acetaminophen, morphine, buprenorphine transdermal patch and pregabalin for 8 weeks, with a 4\u2010week washout period. Medications were governed by the\n SPTP<\/jats:styled-content>\n and each participant's existing prescriptions. We obtained pain intensity scores from 327 patients (intervention\n n<\/jats:italic>\n \u2009=\u2009164, control\n n<\/jats:italic>\n \u2009=\u2009163) at five time points assessed by the primary outcome measure, Mobilization\u2010Observation\u2010Behaviour\u2010Intensity\u2010Dementia\u20102 (\n MOBID<\/jats:styled-content>\n \u20102) Pain Scale. The secondary outcome was activities of daily living (\n ADL<\/jats:styled-content>\n ). We used a linear intercept mixed model in a two\u2010way repeated measures configuration to assess change over time and between groups.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The\n SPTP<\/jats:styled-content>\n conferred significant benefit in\n MOBID<\/jats:styled-content>\n \u20102 scores compared with the control group [average treatment effect (\n ATE<\/jats:styled-content>\n ) \u22121.388;\n p<\/jats:italic>\n \u2009<\u20090.001] at week 8, and\n MOBID<\/jats:styled-content>\n \u20102 scores worsened during the washout period (\n ATE<\/jats:styled-content>\n \u2009=\u2009\u22120.701;\n p<\/jats:italic>\n \u2009=\u20090.022). Examining different analgesic treatments, benefit was conferred to patients receiving acetaminophen compared with the controls at week 2 (\n ATE<\/jats:styled-content>\n \u2009=\u2009\u22120.663;\n p<\/jats:italic>\n \u2009=\u20090.010), continuing to increase until week 8 (\n ATE<\/jats:styled-content>\n \u2009=\u2009\u22121.297;\n p<\/jats:italic>\n \u2009<\u20090.001). Although there were no overall improvements in\n ADL<\/jats:styled-content>\n , an increase was seen in the group receiving acetaminophen (\n ATE<\/jats:styled-content>\n \u2009=\u2009+1.0;\n p<\/jats:italic>\n \u2009=\u20090.022).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Pain medication significantly improved pain in the intervention group, with indications that acetaminophen also improved\n ADL<\/jats:styled-content>\n function.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/ejp.523","type":"journal-article","created":{"date-parts":[[2014,5,13]],"date-time":"2014-05-13T06:30:37Z","timestamp":1399962637000},"page":"1490-1500","source":"Crossref","is-referenced-by-count":78,"title":["Impact of a stepwise protocol for treating pain on pain intensity in nursing home patients with dementia: A cluster randomized trial"],"prefix":"10.1002","volume":"18","author":[{"given":"R.K.","family":"Sandvik","sequence":"first","affiliation":[{"name":"Department of Global Public Health and Primary Care Centre for Elderly\u2010 and Nursing Home Medicine University of Bergen Norway"},{"name":"Institute for Nursing Subjects Bergen University College Norway"},{"name":"Centre for Old Age Psychiatric Research Innlandet Hospital Trust Ottestad Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Selbaek","sequence":"additional","affiliation":[{"name":"Centre for Old Age Psychiatric Research Innlandet Hospital Trust Ottestad Norway"},{"name":"Ageing and Health Norwegian Centre for Research Education and Service Development Vestfold Hospital Trust, T\u00f8nsberg Norway"},{"name":"Akershus University Hospital L\u00f8renskog Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Seifert","sequence":"additional","affiliation":[{"name":"Heart Department Haukeland University Hospital Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Aarsland","sequence":"additional","affiliation":[{"name":"Department of Neurobiology Care Sciences and Society KI\u2010Alzheimer Disease Research Center Karolinska Institute (KI) Solna Sweden"},{"name":"Center for Age\u2010Related Medicine Stavanger University Hospital Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Ballard","sequence":"additional","affiliation":[{"name":"Center for Age\u2010Related Medicine Stavanger University Hospital Norway"},{"name":"The Wolfson Wing & Hodgkin Building Guys Campus Kings College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Corbett","sequence":"additional","affiliation":[{"name":"The Wolfson Wing & Hodgkin Building Guys Campus Kings College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.S.","family":"Husebo","sequence":"additional","affiliation":[{"name":"Department of Global Public Health and Primary Care Centre for Elderly\u2010 and Nursing Home Medicine University of Bergen Norway"},{"name":"Center for Age\u2010Related Medicine Stavanger University Hospital Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,5,13]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2009.10.008"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S36739"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2006.12.017"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2009.02376.x"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2318-13-14"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/JGP.0b013e31818cd3d3"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-200831060-00004"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2004.52305.x"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2005.53572.x"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.1155"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/geronj\/44.3.M77"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/13607869856560"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2012.53"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11940-012-0166-9"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2010.03170.x"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e3181e89905"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3940(00)00769-2"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(03)00173-8"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.930070706"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3956(75)90026-6"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/57.4.M236"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2007.10.012"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2012.11.002"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.2165\/11599460-000000000-00000"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(99)00368-X"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/nur.4770150506"},{"key":"e_1_2_12_28_1","first-page":"S1064","article-title":"The response of agitated behaviour to pain management in persons with dementia","volume":"12","author":"Husebo B.S.","year":"2013","journal-title":"Am J Geriatr Psychiatry"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d4065"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-6712.2008.00606.x"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2008.03.001"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2006.10.016"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-6712.2009.00710.x"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.507"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70169-8"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/1533317506288949"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2702.2010.03695.x"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-148-2-200801150-00010"},{"key":"e_1_2_12_39_1","first-page":"61","article-title":"Functional evaluation: The Barthel index","volume":"14","author":"Mahoney F.I.","year":"1965","journal-title":"Md State Med J"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.906"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1124\/mol.106.023309"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1533-2500.2010.00378.x"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2005.06.010"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2013.05.002"},{"key":"e_1_2_12_45_1","first-page":"104","article-title":"The Global Deterioration Scale for assessment of primary degenerative dementia","volume":"33","author":"Reisberg B.","year":"1982","journal-title":"Am J Psychiatry"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2004.05.001"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40266-012-0001-8"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1521\/psyc.66.2.133.20618"},{"key":"e_1_2_12_49_1","volume-title":"Linear Mixed Models for Longitudinal Data","author":"Verbeke G.","year":"2000"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61049-1"},{"key":"e_1_2_12_51_1","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.2337\/diacare.27.5.1047","article-title":"Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030","volume":"5","author":"Wild S.","year":"2004","journal-title":"Diabetes Care"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11940-011-0113-1"}],"container-title":["European Journal of Pain"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fejp.523","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ejp.523","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ejp.523","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ejp.523","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T04:25:00Z","timestamp":1696566300000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ejp.523"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,5,13]]},"references-count":51,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2014,11]]}},"alternative-id":["10.1002\/ejp.523"],"URL":"https:\/\/doi.org\/10.1002\/ejp.523","archive":["Portico"],"relation":{},"ISSN":["1090-3801","1532-2149"],"issn-type":[{"value":"1090-3801","type":"print"},{"value":"1532-2149","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,5,13]]}}}