Analgetika beim geriatrischen Patienten

Gosch, Markus

doi:10.1007/s00391-015-0922-z

Cited by 12 publications

(3 citation statements)

References 51 publications

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“…To date, the potential interaction risk of metamizole has not been sufficiently addressed in research [41]. The same is true for the impact of paracetamol on diagnosed hypertension [42].…”

Section: Discussionmentioning

confidence: 99%

Chronic Pain: How Challenging Are DDIs in the Analgesic Treatment of Inpatients with Multiple Chronic Conditions?

et al. 2017

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BackgroundChronic pain is common in multimorbid patients. However, little is known about the implications of chronic pain and analgesic treatment on multimorbid patients. This study aimed to assess chronic pain therapy with regard to the interaction potential in a sample of inpatients with multiple chronic conditions.Methods and FindingsWe conducted a retrospective study with all multimorbid inpatients aged ≥18 years admitted to the Department of Internal Medicine of University Hospital Zurich in 2011 (n = 1,039 patients). Data were extracted from the electronic health records and reviewed. We identified 433 hospitalizations of patients with chronic pain and analyzed their combinations of chronic conditions (multimorbidity). We then classified all analgesic prescriptions according to the World Health Organization (WHO) analgesic ladder. Furthermore, we used a Swiss drug-drug interactions knowledge base to identify potential interactions between opioids and other drug classes, in particular coanalgesics and other concomitant drugs. Chronic pain was present in 38% of patients with multimorbidity. On average, patients with chronic pain were aged 65.7 years and had a mean number of 6.6 diagnoses. Hypertension was the most common chronic condition. Chronic back pain was the most common painful condition. Almost 90% of patients were exposed to polypharmacotherapy. Of the chronic pain patients, 71.1% received opioids for moderate to severe pain, 43.4% received coanalgesics. We identified 3,186 potential drug-drug interactions, with 17% classified between analgesics (without coanalgesics).ConclusionsAnalgesic drugs-related DDIs, in particular opioids, in multimorbid patients are often complex and difficult to assess by using DDI knowledge bases alone. Drug-multimorbidity interactions are not sufficiently investigated and understood. Today, the scientific literature is scarce for chronic pain in combination with multiple coexisting medical conditions and medication regimens. Our work may provide useful information to enable further investigations in multimorbidity research within the scope of potential interactions and chronic pain.

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“…To date, the potential interaction risk of metamizole has not been sufficiently addressed in research [41]. The same is true for the impact of paracetamol on diagnosed hypertension [42].…”

Section: Discussionmentioning

confidence: 99%

Chronic Pain: How Challenging Are DDIs in the Analgesic Treatment of Inpatients with Multiple Chronic Conditions?

et al. 2017

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“…Schmerztherapie ist bei geriatrischen Patienten besonders anspruchsvoll [7]. Gefahrenpotenzial bieten vor allem ▶ Komorbiditäten, ▶ Polypharmazie und ▶ eingeschränkte Organreserven.…”

Section: Häufig Untertherapiert | Die Medikamentöseunclassified

“…NSAR: riskante Selbstmedikation | Analgetika der WHOStufe I stellen mit über 60 % den größten Anteil von "Overthecounter"Präparaten, also nichtärztlich verordneter Selbstmedikation, dar [7]. Bei ca.…”

Section: Nicht-opioid-analgetikaunclassified

Schmerztherapie im Alter

Eiche¹,

Schache²

2016

Dtsch med Wochenschr

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Pains belong to the most frequent reasons for a doctor's visit. In elderly people, it is the result of progressive degenerative processes (e. g. , arthrosis, Osteoarthritis, degenerative spinal changes) and a higher prevalence of cancer disease to a further increase of the patients who suffer unnecessarily from pains. By the increasing polymorbidity (e.g. diabetes mellitus, vascular disease) and a declining immune competence, the prevalence of polyneuropathy and post-herpetic neuralgia rises. Insufficiently treated chronic or periodically returning pain can lead to serious interferences of the physical, cognitive and social everyday competence and therefore to a limited quality of life. These facts shows the relevance of a sufficient pain therapy in geriatric patients. Nevertheless, on account of existing comorbidity, polypharmacy as well as of impaired organ function, the pharmacological pain therapy in old patients also poses a potential hazard. Although pain prevalence is higher with geriatric than with younger patients, significantly less analgesics are prescribed in the elderly population. This results from existing uncertainties at the treating doctors as well as the complicated pain capture, in particular with cognitive affected patients. The present article should indicate options of treatment for geriatric pain patients.

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Rehabilitation nach hüft- und knieendoprothetischer Versorgung älterer Menschen

Bork¹

2016

Orthopäde

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Due to current demographic developments with a continuous increase in average life expectancy and improved medical treatment, the number of elderly patients with joint replacement of the lower extremities also has increased in recent years. Most of these patients have not only one but several chronic diseases requiring treatment and medication. Drug-drug interaction and functional restrictions of the elderly additionally reduce the postoperative psychophysical capacity; therefore, special knowledge in rehabilitative treatment and pain management is necessary. Physiotherapy and exercise should include training of mobility, endurance, strength, coordination and training in activities of daily living. The individual constitution and pain during exercise must always be taken into consideration. Rehabilitative outcome is dependent on a functioning cooperation of an interdisciplinary rehabilitation team and requires an organized, holistic treatment approach in interconnected structures, which aims at rapid postoperative mobilization.

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Analgetika beim geriatrischen Patienten

Cited by 12 publications

References 51 publications

Chronic Pain: How Challenging Are DDIs in the Analgesic Treatment of Inpatients with Multiple Chronic Conditions?

Chronic Pain: How Challenging Are DDIs in the Analgesic Treatment of Inpatients with Multiple Chronic Conditions?

Schmerztherapie im Alter

Rehabilitation nach hüft- und knieendoprothetischer Versorgung älterer Menschen

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