Deficits in pain medication in older adults with chronic pain receiving home care: A cross-sectional study in Germany

To analyze the pattern and appropriateness of pain medications in older adults receiving home care. We performed a prospective cross-sectional study in patients ≥65 years old having chronic pain and receiving home care in Berlin, Germany. Data on prescribed pain medications were collected using self...

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Published in:PloS one 2020-02, Vol.15 (2), p.e0229229
Main Authors: Schneider, Juliana, Algharably, Engi, Budnick, Andrea, Wenzel, Arlett, Dräger, Dagmar, Kreutz, Reinhold
Format: Article
Language:English
Subjects:
Adults
Aged, 80 and over
Ambulatory care
Analgesics
Analysis
Anti-inflammatory agents
Biology and Life Sciences
Chronic pain
Chronic Pain - drug therapy
Cognition
Cognitive ability
Cross-Sectional Studies
Dementia
Dementia disorders
Demographics
Dipyrone
Drugs
Elderly
Evaluation
Female
Females
Germany
Gerontology
Home care
Home Care Services - statistics & numerical data
Home health care
Humans
Inflammation
Male
Measures
Medical research
Medicine and Health Sciences
Narcotics
Nonsteroidal anti-inflammatory drugs
Nurses
Nursing
Nursing care
Older people
Opiates
Opioids
Pain
Pain management
Patients
Pattern analysis
People and Places
Pharmacology
Polypharmacy
Population
Quality of Health Care - statistics & numerical data
Rehabilitation
Sociology
Steroidal anti-inflammatory agents
Toxicology
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creator Schneider, Juliana
Algharably, Engi
Budnick, Andrea
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Dräger, Dagmar
Kreutz, Reinhold
description To analyze the pattern and appropriateness of pain medications in older adults receiving home care. We performed a prospective cross-sectional study in patients ≥65 years old having chronic pain and receiving home care in Berlin, Germany. Data on prescribed pain medications were collected using self-reported information, nursing documents, and medication plans during interviews at home. Pain intensity was determined with the numeric rating scale (NRS) and the Pain Assessment In Advanced dementia (PAINAD) scale. The Pain Medication Appropriateness Scale score (SPMAS) was applied to evaluate inappropriateness (i.e. a score ≤67) of pain medication. Overall 322 patients with a mean age of 82.1 ± 7.4 years (71.4% females) were evaluated. The average pain intensity scores during the last 24 hours were 5.3 ± 2.1 and 2.3 ± 2.3 on NRS and PAINAD scale (range 0-10, respectively). Sixty (18.6%) patients did not receive any pain medication. Among the treated patients, dipyrone was the most frequently prescribed analgesic (71.4%), while 50.8% and 19.1% received systemic treatment with opioids and non-steroidal anti-inflammatory drugs, respectively. The observed median SPMAS was 47.6 (range 0-100) with 58 (18.0%) of patients achieving appropriate values. Half of the patients were treated with scheduled, while 29.9% were only treated with on-demand medications. Cognitive status had no effect on appropriateness of pain treatment. We observed substantial deficits in dosing patterns and appropriateness of pain medication in older adults with pain receiving home care. This applied to both patients with and without severe cognitive impairment.
doi_str_mv 10.1371/journal.pone.0229229
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Among the treated patients, dipyrone was the most frequently prescribed analgesic (71.4%), while 50.8% and 19.1% received systemic treatment with opioids and non-steroidal anti-inflammatory drugs, respectively. The observed median SPMAS was 47.6 (range 0-100) with 58 (18.0%) of patients achieving appropriate values. Half of the patients were treated with scheduled, while 29.9% were only treated with on-demand medications. Cognitive status had no effect on appropriateness of pain treatment. We observed substantial deficits in dosing patterns and appropriateness of pain medication in older adults with pain receiving home care. 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We performed a prospective cross-sectional study in patients ≥65 years old having chronic pain and receiving home care in Berlin, Germany. Data on prescribed pain medications were collected using self-reported information, nursing documents, and medication plans during interviews at home. Pain intensity was determined with the numeric rating scale (NRS) and the Pain Assessment In Advanced dementia (PAINAD) scale. The Pain Medication Appropriateness Scale score (SPMAS) was applied to evaluate inappropriateness (i.e. a score ≤67) of pain medication. Overall 322 patients with a mean age of 82.1 ± 7.4 years (71.4% females) were evaluated. The average pain intensity scores during the last 24 hours were 5.3 ± 2.1 and 2.3 ± 2.3 on NRS and PAINAD scale (range 0-10, respectively). Sixty (18.6%) patients did not receive any pain medication. Among the treated patients, dipyrone was the most frequently prescribed analgesic (71.4%), while 50.8% and 19.1% received systemic treatment with opioids and non-steroidal anti-inflammatory drugs, respectively. The observed median SPMAS was 47.6 (range 0-100) with 58 (18.0%) of patients achieving appropriate values. Half of the patients were treated with scheduled, while 29.9% were only treated with on-demand medications. Cognitive status had no effect on appropriateness of pain treatment. We observed substantial deficits in dosing patterns and appropriateness of pain medication in older adults with pain receiving home care. This applied to both patients with and without severe cognitive impairment.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>32084203</pmid><doi>10.1371/journal.pone.0229229</doi><tpages>e0229229</tpages><orcidid>https://orcid.org/0000-0002-6015-8251</orcidid><oa>free_for_read</oa></addata></record>
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source Publicly Available Content Database; PubMed Central; Sociological Abstracts
subjects Adults
Aged, 80 and over
Ambulatory care
Analgesics
Analysis
Anti-inflammatory agents
Biology and Life Sciences
Chronic pain
Chronic Pain - drug therapy
Cognition
Cognitive ability
Cross-Sectional Studies
Dementia
Dementia disorders
Demographics
Dipyrone
Drugs
Elderly
Evaluation
Female
Females
Germany
Gerontology
Home care
Home Care Services - statistics & numerical data
Home health care
Humans
Inflammation
Male
Measures
Medical research
Medicine and Health Sciences
Narcotics
Nonsteroidal anti-inflammatory drugs
Nurses
Nursing
Nursing care
Older people
Opiates
Opioids
Pain
Pain management
Patients
Pattern analysis
People and Places
Pharmacology
Polypharmacy
Population
Quality of Health Care - statistics & numerical data
Rehabilitation
Sociology
Steroidal anti-inflammatory agents
Toxicology
title Deficits in pain medication in older adults with chronic pain receiving home care: A cross-sectional study in Germany
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