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Prescribing Patterns of Pain Medication in Hospitalized Elderly Patients with Non-Cancer Pain  

Nam, Ki Nam (Department of Pharmacy, Kangwon National University Hospital)
Choi, Eun Ok (Department of Pharmacy, Kangwon National University Hospital)
Kim, Beam Hae (Department of Pharmacy, Kangwon National University Hospital)
Seong, Sae Ra (College of Pharmacy, Kangwon National University)
Heo, Yoo Jeong (College of Pharmacy, Kangwon National University)
Lee, Kyeong Ju (College of Pharmacy, Kangwon National University)
Lee, Yu Jeung (College of Pharmacy, Kangwon National University)
Publication Information
Korean Journal of Clinical Pharmacy / v.25, no.3, 2015 , pp. 145-150 More about this Journal
Abstract
Objective: Pain is very common in the elderly, so there is a high prevalence of analgesic use among this population. The purpose of this study was to assess patterns of analgesic use and evaluate factors associated with analgesic use in elderly patients. Method: The subjects of this study were patients over 65 years old hospitalized in a teaching hospital located in Chuncheon-si, Korea between January 1, 2014 and March 31, 2014. Data collection regarding analgesic prescriptions and baseline characteristics was conducted using computerized hospital database by medical information team. Logistic regression analysis was used to identify factors related to analgesic use. Results: A total of 2,394 patients were finally included. Among these patients, 700 (29.2%) took analgesics; 521 (74.4%) out of these 700 patients were received opioid analgesics and 179 (25.6%) were received only non-opioid analgesics. The most frequently prescribed opioid analgesic was pethidine (45.7%), and the most frequently prescribed non-opioid analgesic was acetaminophen (44.1%). Fracture was associated with increased odds of opioid analgesic prescriptions (OR = 2.766, 95% CI = 2.019-3.790, p < 0.001) and any analgesic prescriptions (OR = 2.394, 95% CI = 1.766-3.244, p < 0.001). Stroke or cerebral infarction was associated with decreased odds of opioid analgesic prescriptions (OR = 0.636, 95% CI = 0.471-0.858, p = 0.003). Conclusion: A significant proportion of hospitalized elderly patients use analgesics. Health care professionals should consider factors associated with analgesic use in this population to improve pain management.
Keywords
pain; analgesics; opioids; elderly; management;
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1 Wang H, Dwyer-Lindgren L, Lofgren KT, et al. Age-specific and sexspecific mortality in 187 countries, 1970-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2013;380(9859):2071-94.   DOI
2 Gibson SJ. IASP global year against pain in older persons: highlighting the current status and future perspectives in geriatric pain. Expert Rev Neurother 2007;7(6):627-35.   DOI
3 Maxwell CJ, Dalby DM, Slater M, et al. The prevalence and management of current daily pain among older home care clients. Pain 2008;138(1):208-16.   DOI
4 Breivik H, Collett B, Ventafridda V, et al. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain 2006;10(4):287-333.   DOI
5 Noble M, Treadwell JR, Tregear SJ, et al. Long-term opioid management for chronic noncancer pain. Cochrane Database Syst Rev 2010;1(1):CD006605.
6 Lapane KL, Quilliam BJ, Chow W, et al. Pharmacologic management of non-cancer pain among nursing home residents. J Pain Symptom Manage 2013;45(1):33-42.   DOI
7 Won AB, Lapane KL, Vallow S, et al. Persistent nonmalignant pain and analgesic prescribing patterns in elderly nursing home residents. J Am Geriatr Soc 2004;52(6):867-74.   DOI
8 Siddall PJ, Cousins MJ. Persistent pain as a disease entity: implications for clinical management. Anesth Analg 2004;99(2):510-20.   DOI
9 Ferrell B, Argoff CE, Epplin J, et al. Pharmacological management of persistent pain in older persons. J Am Geriatr Soc 2009;57(8):1331-46.   DOI
10 King SA. Chronic Pain Management in the Elderly: An Update on Safe, Effective Options. Consultant 2012;52(5):326-31.
11 Coluzzi F, Pappagallo M. Opioid therapy for chronic noncancer pain: practice guidelines for initiation and maintenance of therapy. Minerva anestesiol 2004;71(7-8):425-33.
12 Abdulla A, Adams N, Bone M, et al. Guidance on the management of pain in older people. Age and ageing 2013;42(Suppl 1):i1-57.   DOI
13 Tracy B, Morrison RS. Pain management in older adults. Clin Ther 2013;35(11):1659-68.   DOI
14 Veal FC, Bereznicki LR, Thompson AJ, et al. Pharmacological management of pain in Australian aged care facilities. Age and ageing 2014;43(6):851-6.   DOI
15 Gianni W, Ceci M, Bustacchini S, et al. Opioids for the treatment of chronic non-cancer pain in older people. Drugs Aging 2009;26(1):63-73.   DOI
16 Achterberg WP, Pieper MJ, van Dalen-Kok AH, et al. Pain management in patients with dementia. Clin Interv Aging 2013;8:1471-82.
17 Scherder E, Herr K, Pickering G, et al. Pain in dementia. Pain 2009;145(3):276-8.   DOI
18 Lee CW, Muo CH, Liang JA, Sung FC, Kao CH. Association of intensive morphine treatment and increased stroke incidence in prostate cancer patients: a population-based nested case-control study. Jpn J Clin Oncol 2013;43(8):776-81.   DOI
19 Pergolizzi J, Boger RH, Budd K, et al. Opioids and the management of chronic severe pain in the elderly: consensus statement of an International Expert Panel with focus on the six clinically most often used World Health Organization Step III opioids (buprenorphine, fentanyl, hydromorphone, methadone, morphine, oxycodone). Pain Pract 2008;8(4):287-313.   DOI
20 Zorowitz RD, Smout RJ, Gassaway JA, et al. Usage of pain medications during stroke rehabilitation: the Post-Stroke Rehabilitation Outcomes Project (PSROP). Top Stroke Rehabil 2005;12(4):37-49.   DOI
21 Mangoni AA, Jackson SH. Age-related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications. Br J Clin Pharmacol 2004;57(1):6-14.   DOI