Pain Treatment in Elderly Persons With and Without Dementia
Pain Treatment in Elderly Persons With and Without Dementia
复制标题
患有和不患有痴呆症的老年人的疼痛治疗
作者：
Ylva Haasum;J. Fastbom;L. Fratiglioni;I. Kåreholt;K. Johnell
摘要背景：之前的几项研究报告称，老年痴呆症患者的疼痛治疗不足。还有人提出，痴呆症患者可能面临精神药物治疗疼痛不当的风险。
目的：本研究的目的是在考虑居住环境和疼痛相关疾病后，调查痴呆症患者是否与非痴呆症患者一样有可能接受药物疼痛治疗。我们还旨在调查精神药物的使用是否与痴呆症患者和非痴呆症患者的疼痛有关。
方法：我们使用 SNAC-K（瑞典国家老龄化与护理研究 - Kungsholmen）的基线数据。我们分析了 2610 名年龄 > 65 岁的参与者的镇痛药和精神药物的使用情况、疼痛相关诊断的患病率、自我报告的疼痛、痴呆状况和居住环境。
结果：在痴呆症患者中，46% 的人至少使用一种镇痛药，而没有痴呆症的患者中这一比例为 25%。尽管痴呆症患者报告疼痛的频率低于未患痴呆症的人，但与疼痛相关的诊断的患病率相似。在调整个人因素和居住环境（自己的家/机构）后，痴呆症患者使用扑热息痛（对乙酰氨基酚）和精神药物的可能性较高，而使用任何镇痛药、阿片类药物和非甾体抗炎药则没有显着差异。此外，与疼痛相关的诊断与痴呆症患者使用精神药物有关。
结论：在调整混杂因素后，痴呆症患者使用扑热息痛的可能性较高，并且与非痴呆症患者使用任何镇痛药、阿片类药物和非甾体抗炎药的可能性大致相同。这可能反映出最近人们对痴呆症患者疼痛和疼痛管理的认识有所提高，而之前的研究报告称痴呆症患者镇痛药使用不足。然而，需要进一步研究来分析痴呆症患者是否在镇痛药物类型、疼痛强度、适应症、剂量和治疗方案方面得到适当的疼痛治疗。
AbstractBackground: Several previous studies have reported an undertreatment of pain in elderly persons with dementia. It has also been suggested that persons with dementia may be at risk for inappropriate treatment of pain with psychotropics.
Objectives: The objective of this study was to investigate if persons with dementia are as likely as persons without dementia to receive pharmacological pain treatment, after taking into account residential setting and pain-related disorders. We also aimed to investigate whether use of psychotropics is related to pain in persons with and without dementia.
Methods: We used baseline data from the SNAC-K (Swedish National Study of Aging and Care — Kungsholmen). We analysed use of analgesics and psychotropics, prevalence of pain-related diagnoses, self-reported pain, dementia status and residential setting in 2610 participants aged >65 years.
Results: Of the persons with dementia, 46% used at least one analgesic drug compared with 25% of those without dementia. Although persons with dementia reported pain less frequently than persons without dementia, the prevalence of pain-related diagnoses was similar. After adjustment for individual factors and residential setting (own home/institution), persons with dementia had a higher probability of use of paracetamol (acetaminophen) and psychotropics, whereas there were no significant differences in use of any analgesic, opioids and NSAIDs. Furthermore, having a pain-related diagnosis was associated with use of psychotropics in persons with dementia.
Conclusions: Persons with dementia had a higher probability of use of paracetamol and were about as likely as persons without dementia to use any analgesic, opioids and NSAIDs, after adjustment for confounders. This may reflect a recent increased awareness of pain and pain management in persons with dementia, compared with previous studies that have reported an underuse of analgesics in persons with dementia. However, further research is needed to analyse if persons with dementia are appropriately treated for pain with regard to type of analgesic drug, pain intensity, indication, dosage and regimen.
社区居民痴呆症患者的疼痛：频率、强度以及患者和护理人员报告之间的一致性。
DOI：
10.1016/j.jpainsymman.2004.04.012
发表时间：
2004
期刊：
Journal of pain and symptom management.
影响因子：
--
作者：
Shega,JosephW;Hougham,GavinW;Stocking,CarolB;Cox-Hayley,Deon;Sachs,GregA
通讯作者：
Sachs,GregA
影响因子：
4.7
作者：
Morrison, RS;Siu, AL
通讯作者：
Siu, AL
疗养院居民躁动的医学相关性。
影响因子：
3.5
作者：
Cohen-Mansfield,J;Billig,N;Lipson,S;Rosenthal,AS;Pawlson,LG
通讯作者：
Pawlson,LG