Analgesic purchases among older adults – a population-based study

Abstract

Background Pain is a frequent and inevitable factor affecting the quality of life among older people. Several studies have highlighted the ineffectiveness of treating chronic pain among the aged population, and little is known about the prevalence of analgesics administration among community-dwelling older adults. The objective was to examine older adults’ prescription analgesic purchases in relation to SF-36 pain in a population-based setting. Methods One thousand four hundred twenty community-dwelling citizens aged 62–86 years self-reported SF-36 bodily pain (pain intensity and pain-related interference) scores for the previous 4 weeks. The Social Insurance Institution of Finland register data on analgesic purchases for 6 months prior to and 6 months after the questionnaire data collection were considered. Special interest was focused on factors related to opioid purchases. Results Of all participants, 84% had purchased prescription analgesics during 1 year. NSAIDs were most frequently purchased (77%), while 41% had purchased paracetamol, 32% opioids, 17% gabapentinoids, and 7% tricyclic antidepressants. Age made no marked difference in purchasing prevalence. The number of morbidities was independently associated with analgesic purchases in all subjects and metabolic syndrome also with opioid purchases in subjects who had not reported any pain. Discussion Substantial NSAID and opioid purchases emerged. The importance of proper pain assessment and individual deliberation in terms of analgesic contraindications and pain quality, as well as non-pharmacological pain management, need to be highlighted in order to optimize older adults’ pain management.

Prevalence of Musculoskeletal Pain and Analgesic Treatment Among Community-Dwelling Older Adults: Changes from 1999 to 2019

“…The studies reporting regular prescribed and pro re nata (as needed) analgesics [ 19 ] and even over-the-counter analgesics [ 24 ] have shown a higher prevalence of analgesic use than that observed in our study. In fact, the short-term use of analgesics may be much more widespread than the regular use we investigated.…”

“…Recent developments in analgesic prescribing in geriatric populations have not been thoroughly examined. Opioid use in older populations has been addressed in only a few studies [12,18,19], and overall pain management in the oldest-old outside institutionalized settings has received little attention. This study analyzed time trends in analgesics use among 75-to 95-year-old community-dwelling persons using cohort data from 1999 to 2019.…”

Prolonged use of paracetamol and the prescribing patterns on rehabilitation facilities

“…The additional risk factors associated with ageing, such as multiple comorbidities, polypharmacy and individual health conditions, can significantly affect the mechanism of paracetamol (Mian et al, 2018). Moreover, the number of other medications containing paracetamol (Mitchell et al, 2020) increases the risk of accidental overdosing for older individuals taking multiple medications without realising they have surpassed the daily recommended dose (Marttinen et al, 2021). This study did not examine the paracetamol use in conjunction with other medicines that may contain paracetamol.…”

“…A population-based study reported more than three-quarters of adults aged 62-86 years had prescriptions for analgesia in 2012, of which 41% had been for paracetamol, excluding over the counter (OTC) paracetamol. This suggests that the actual incidence of paracetamol use in elderly patients may be higher than reported (Marttinen et al, 2021). Many medications contain paracetamol as an active ingredient, which increases the risk of exceeding the daily paracetamol dose of 4 g among older people who take multiple medications (Mitchell et al, 2020).…”

Total flavonoid content and analgesic activity of ethyl acetate fraction of Indian jujube (Ziziphus mauritiana lamk) leaves

“…Pain can interfere with social function and quality of life for sufferers and is the reason patients often use analgesics. 1 and little is known about the prevalence of analgesics administration among communitydwelling older adults. The objective was to examine older adults' prescription analgesic purchases in relation to SF-36 pain in a population-based setting.…”