Table 5 Set of indicators to assess the quality of chronic pain management in Chinese community-dwelling older adults (three primary indicators, nine secondary indicators, and 36 tertiary indicators)

Structure quality

Basic conditions

Types of analgesic treatment equipment

Types of analgesic drugs

Types of non-pharmacological pain relief methods

Numbers of wards and beds

Pain assessment tools (single-dimensional assessment tools such as numeric rating scale and verbal rating scale, and multidimensional assessment tools such as brief pain inventory, geriatric pain assessment scale, pain disability index, etc.)

Human resources

Multidisciplinary pain management team

Composition of personnel

Composition of professional titles

System

Organizational system for multidisciplinary pain management

Guidelines for managing chronic pain in older adults

Continuous quality improvement in pain management

Process quality

Pain assessment

Screening for pain upon patient admission/change in condition

Assessing the characteristics of pain occurrence (location, intensity, nature, timing of pain, etc.)

Assessing the factors related to pain occurrence (e.g., invasive procedures like punctures, catheterization, extubation, etc.)

Assessing the impact of pain on the patient’s psychosocial status (emotions, self-efficacy, financial burden, etc.)

Assessing the impact of pain on the patient’s physiological status (nutritional status, quality of life, potential adverse risks of pain treatment, etc.)

Pre-administration assessment of fall risk, declining cognitive function, and respiratory and hepatic/renal functional impairments in older adults

Pharmacological intervention for pain

Comprehensive information disclosure and informed consent for pain relief

Patient and family involvement in pain relief decisions

Prophylactic use of analgesics for patients with chronic pain

Individualized pain relief based on the organ’s functional status and reserve capacity for patients with pain

Opting for the lowest effective dose and appropriate route of administration based on pain severity during drug interventions

Observing patients for adverse reactions during medication interventions

Timely assessment and records of pain relief efficacy based on medication use

Non-pharmacological intervention for pain

Preference for non-pharmacological interventions within the tolerable range of chronic pain intensity in older adult patients

Making appropriate clinical decisions based on the patient’s specific condition, providing psychological interventions (cognitive-behavioral therapy, mindfulness meditation, biofeedback, guided imagery, pain diaries, etc.)

Making appropriate clinical decisions based on the patient’s specific condition to provide exercise therapy, considering individual preferences for exercise type, and designing exercise types based on personal abilities and needs, including exercises related to strength, flexibility, endurance, and balance (tai chi, qigong, yoga, etc.)

Making appropriate clinical decisions based on the patient’s specific condition to provide physical therapy (hot/cold therapy, acupuncture, massage, transcutaneous electrical nerve stimulation, etc.)

Recommending the combined use of psychosocial interventions, exercise therapy, and physical therapy to alleviate pain in older adult patients based on their physical conditions and preferences

Timely assessment and documentation of non-pharmacological pain intervention processes and post-intervention pain relief efficacy

Pain health education

Determining the content, form, frequency, and timing of pain management health education based on the patient’s age, cultural background, disease condition, psychological status, needs, and pain relief goals

Educating patients and family members on pain management knowledge, attitude, skills, etc.

Outcome quality

Pain relief effects

Treatment rate of moderate to severe pain

Proportion of older adult patients showing control of chronic pain

Analgesic assessment

Analgesic adequacy rate

Patient and family satisfaction with pain management