Management of nonmalignant pain in home-dwelling older people: A population-based survey
Management of nonmalignant pain in home-dwelling older people: A population-based survey
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DOI：
10.1046/j.1532-5415.2002.50517.x
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发表时间：
2002-11-01
影响因子：
6.3
通讯作者：
Tilvis, RS
中科院分区：
文献类型：
--
作者：
Pitkala, KH;Strandberg, TE;Tilvis, RS
目的：研究居家老年人使用处方止痛药与关节或背部疼痛的关系，研究10年来止痛药使用的变化，并研究1999年处方止痛药与胃肠道保护药物的联合使用。设计：间隔10年的横断面邮寄调查。地点：芬兰赫尔辛基。参与者：1989年出生于1904年、1909年和1914年的大龄出生队列的随机样本（n = 644），以及1999年出生于1914年、1919年和1924年的三个独立队列的随机样本（n = 3，000）.测量：使用各种类型的止痛和保护胃肠道药物，处方和非处方药。关节和背部疼痛的经验，干扰日常functions.Results：居家老年人的反应率分别为83%，1989年和81%，1999年。虽然使用止痛药自我治疗的比例在10年内从28.5%上升到41.4%，但在1999年，只有35.5%至38.2%的关节或背部疼痛患者经常使用止痛药。在使用处方药的患者中，57.5%使用非甾体类抗炎药（NSAID），20.9%使用对乙酰氨基酚，18.5%使用弱阿片类药物。只有五分之一的服用NSAID的人同时服用胃保护药物。结论：疼痛是显着治疗不足，在社区居住的老年人，这可能会对他们的福祉和功能产生严重影响。尽管我们注意到处方止痛药的使用趋向于安全，但仍需做出重大努力以实施循证实践。疼痛的自我治疗在10年内有所增加，这可能会降低老年人使用止痛药的整体安全性。
OBJECTIVES: To investigate use of prescribed analgesic drugs in relation to experience of joint or back pain in a home-dwelling older population, to study changes in the use of analgesic drugs over 10 years, and to investigate concomitant use of protective gastrointestinal drugs with prescribed analgesic drugs in 1999.DESIGN: Cross-sectional mailed surveys 10 years apart.SETTING: Helsinki, Finland.PARTICIPANTS: Random samples of older birth cohorts born in 1904, 1909, and 1914 in 1989 (n = 644), and of three separate cohorts born in 1914, 1919, and 1924 in 1999 (n = 3,000).MEASUREMENTS: Use of various types of analgesic and protective gastrointestinal drugs, prescribed and over the counter. Experience of joint and back pain that interferes with daily functioning.RESULTS: The response rate of home-dwelling older people was 83% in 1989 and 81% in 1999. Although the use of analgesic drugs as self-treatment increased from 28.5% to 41.4% during the 10 years, in 1999, only 35.5% to 38.2% of those suffering joint or back pain that impaired daily functioning had been prescribed an analgesic drug for regular use. Of those using prescribed medication, 57.5% were on nonsteroidal antiinflammatory drugs (NSAIDs), 20.9% acetaminophen, and 18.5% weak opiates. Only one-fifth of those individuals taking NSAIDs were on a concomitant gastroprotective drug.CONCLUSIONS: Pain is markedly undertreated in community-dwelling older people, which may have serious implications for their well-being and functioning. Although we noted a tendency for safety in the use of prescribed analgesic drugs, a significant effort must sill be made to implement evidence-based practice. Self-treatment of pain has increased in 1 decade, which may reduce the overall safety of analgesic drug use among older people.