Regularly Scheduled Acetaminophen for Pain in Long-Term Care: Systematic Review and Meta-Analysis.
Kalee Jack, Eric Lui, Paulien H van Dam et al.
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In 30 seconds
This systematic review and meta-analysis assessed whether regularly scheduled acetaminophen improves pain in long-term care residents. Four randomized controlled trials included 482 residents with moderate-to-severe dementia and mild-to-moderate pain at baseline; treatment was compared with placebo or usual care. Across trials, scheduled acetaminophen did not significantly reduce pain (standardized mean difference, -0.14; 95% CI, -0.39 to 0.11; I 2 = 6%), with moderate-certainty evidence. One study found no significant quality-of-life difference, and adverse-event reporting was limited and inconsistent. The authors conclude that scheduled acetaminophen probably does not improve pain in this population.
Key findings
- Across four randomized trials, pain was not significantly reduced with scheduled acetaminophen versus placebo or usual care (standardized mean difference, -0.14; 95% CI, -0.39 to 0.11; I 2 = 6%).
- The 482 participants had moderate-to-severe dementia and mild-to-moderate pain at baseline.
- One study found no statistically significant quality-of-life difference; adverse-event reporting was limited and inconsistent.
Why it matters
Acetaminophen is often recommended as first-line therapy for pain, but this synthesis found no demonstrated pain benefit from regular scheduling in long-term care residents with dementia and mild-to-moderate pain. The result helps clarify the evidence for this specific population while highlighting that the available evidence does not establish effects on quality of life or provide a consistent account of adverse events.
What to keep in mind
Only four trials were included, and adverse-event reporting was limited and inconsistent. The evidence applies to residents with moderate-to-severe dementia and mild-to-moderate pain at baseline.