Journal of Research in Pharmacy Practice

Abstract Objective: To monitor pain intensity, pain symptoms, and medication use in elderly 
with dementia.
Methods: Nursing home residents above 65 years of age, diagnosed with dementia, 
and showing pain symptoms were included in the study. The patients’ mental status 
was monitored through a mini‑mental state examination score and observations of pain 
symptoms using Part 1 of the Mobilization‑Observation‑Behaviour‑Intensity‑Dementia‑2 
(MOBID‑2) pain scale. Community pharmacists reviewed the patients’ medication use, 
and the prescriptions were compared with guidelines for treatment of geriatric patients. 
Alterations to the patients’ medicine use were forwarded to the general practitioners.
Findings: Sixty‑one nursing home residents diagnosed with dementia were identified, 
15 of these fulfilled the inclusion criteria, and 12 agreed to participate in the study. 
The mean age was 87 years of age (range: 77–96), and 42% of the residents were 
males. The patients’ overall pain intensity was 83% for observations on the numeric 
pain rating scale (NRS) >0 and 67% for NRS ≥3. Most painful were the situations in 
which the residents were to mobilize their legs, turn around to both sides of the bed, 
and when sitting on the bed. The medication reviews identified a total of 95 individual 
prescriptions, and 33% of these were for nervous system medications, followed by 
medicines for the treatment of alimentary tract and metabolism disorders (31% of 
total). Eleven prescriptions for pain medicine were identified; the majority of these 
were for paracetamol and opioids. Seventeen proposals to patients’ medication use 
were suggested, but the general practitioners accepted only 6% of these.
Conclusion: This study indicates that the MOBID‑2 pain scale in combination with 
medication reviews can be used as a tool for optimization of patients’ medication use. 
However, we recommend the conduction of a larger‑scale study in multiple settings, to 
validate our results and the generalizability of the findings.

Abstract Objective: Persons experiencing homelessness are a vulnerable population and are at 
increased risk for morbidity and all‑cause mortality compared to the general population. 
This study sought to evaluate medication use, regular physician visits, and identify health 
conditions among the homeless population of Long Beach, California.
Methods: Two “brown bag” medication review events were held at homeless shelters in 
the Long Beach area. Demographic information, medication use, and comorbid disease states 
were obtained through surveys.
Findings: Three‑fourths of the cohort (95 participants) consisted of males, and the 
average age of participants was 48 years. Psychiatric disorders and cardiovascular disease 
were the most common disease states reported at 32% and 46%, respectively and so were 
medications used in treating these chronic diseases. Medication adherence was found to be a 
significant problem in this population, where more than 30% of patients were nonadherent to 
medications for chronic diseases. Furthermore, foot problems, hearing and vision difficulties 
constitute the most commonly overlooked health problems within the homeless population.
Conclusion: Based on this and other similar finding, we must accept that the homeless 
represent a vulnerable population, and that because of this fact, more programs should be 
focused at improving availability and access to health care among the homeless. Regarding 
the high number of reported health problems in the study, more studies are needed and 
more studies should incorporate screening for foot, hearing, and vision issues, both to 
increase awareness and to provide an opportunity for devising possible solutions to these 
highly preventable conditions.