Review
Nonpharmacological Pain Management for People With Dementia: A Scoping Review Mapping Research Gaps From a Pragmatic Lens
Journal of the American Geriatrics Society (JAGS), v 73(7), pp 2247-2261
01 Jul 2025
PMID: 40052350
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background Nonpharmacological pain interventions are effective but underutilized in people living with dementia (PLWD). Leveraging an implementation lens (i.e., the Readiness Assessment for Pragmatic Trials [RAPT] model) to scope the literature may reveal research gaps contributing to this underutilization. The purpose of this scoping review is to summarize the literature, map the studies to the RAPT model, and identify research gaps. Methods Following Arksey and O'Malley's framework and Preferred Reporting Items for Systematic Review and Meta-Analyses Extension for Scoping Reviews (PRISMA- ScR) guidelines, two reviewers screened, collated, extracted, and mapped data from eligible studies to the 9 RAPT domains (implementation, evidence, risk, feasibility, measurement, cost, acceptability, alignment, and impact). We used descriptive statistics to summarize the studies and the extent to which interventions were mapped to RAPT domains. Results Of 81 studies covering 24 interventions, 64% were in long-term care facilities (LTCFs), 66% reported unspecified pain, and 32% reported unspecified dementia. Of the interventions, the Tailored Activities Program had literature informing the most domains (6 domains), followed by exercise, pain education, and stepwise approaches (5 domains each). Most studies were mapped to the evidence domain (33 studies), few studies to feasibility (7 studies), acceptability (5 studies), and implementation (10 studies) domains, one study to cost, and no studies to risk or impact. Conclusion Despite the variety of nonpharmacological pain interventions studied, there is a notable lack of literature that aligns with the RAPT model. Furthermore, there is limited consideration of the specific pain and dementia conditions, as well as the diverse environments where PLWD reside and receive care. These gaps underscore the need for robust and holistic research to ensure pain interventions are effectively tailored and implemented for PLWD. Starting with acceptability and feasibility studies can establish a foundation for building robust evidence, ensuring practical and well-received interventions before larger-scale clinical trials.
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Details
- Title
- Nonpharmacological Pain Management for People With Dementia: A Scoping Review Mapping Research Gaps From a Pragmatic Lens
- Creators
- Annalisa Na - Drexel University, Physical Therapy (and Rehabilitation Sciences)Justine S. Sefcik - Drexel University, Doctoral NursingLaura N. Gitlin - Drexel University, College of Nursing and Health Professions
- Publication Details
- Journal of the American Geriatrics Society (JAGS), v 73(7), pp 2247-2261
- Publisher
- Wiley
- Number of pages
- 15
- Grant note
- National Institute on Aging; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Aging (NIA)
- Resource Type
- Review
- Language
- English
- Academic Unit
- Doctoral Nursing; College of Nursing and Health Professions; Physical Therapy (and Rehabilitation Sciences)
- Web of Science ID
- WOS:001439151200001
- Scopus ID
- 2-s2.0-86000336700
- Other Identifier
- 991022035266004721
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InCites Highlights
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- Web of Science research areas
- Geriatrics & Gerontology
- Gerontology