Polypharmacy and pain treatment

Gosch, Markus; Böhmdorfer, Birgit; Benvenuti-Falger, Ursula; Dovjak, Peter; Iglseder, Bernhard; Lechleitner, Monika; Otto, Ronald; Roller, Regina E.; Sommeregger, Ulrike

doi:10.1007/s10354-010-0788-z

Cited by 14 publications

(2 citation statements)

References 55 publications

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“…In this way, although men tended to maintain an unusually high MEDD, worse tolerability was observed in women. This is probably due to the higher use of other painkillers such as tramadol and neuromodulators that could have increased the probability of drug-to-drug interactions or the summation of side-effects (35), or due to a different pattern of tolerability between sexes that needs to be studied (11).…”

Section: Demographic Clinical and Therapeutic Outcomesmentioning

confidence: 99%

Long-term deprescription in chronic pain and opioid use disorder patients: Pharmacogenetic and sex differences

Muriel¹,

Escorial

Margarit

et al. 2023

Acta Pharmaceutica

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More than half of patients with opioid use disorder for chronic non-cancer pain (CNCP) reduced their dose through a progressive opioid withdrawal supported by a rotation to buprenorphine and/or tramadol. The aim of this research is to analyse the long-term effectiveness of opioid deprescription taking into account the impact of sex and pharmacogenetics on the inter-individual variability. A cross-sectional study was carried out from October 2019 to June 2020 on CNCP patients who had previously undergone an opioid deprescription (n = 119 patients). Demographic, clinical (pain, relief and adverse events) and therapeutic (analgesic use) outcomes were collected. Effectiveness (< 50 mg per day of morphine equivalent daily dose without any aberrant opioid use behaviour) and safety (number of side-effects) were analysed in relation to sex differences and pharmacogenetic markers impact [OPRM1 genotype (rs1799971) and CYP2D6 phenotypes]. Long-term opioid deprescription was achieved in 49 % of the patients with an increase in pain relief and a reduction of adverse events. CYP2D6 poor metabolizers showed the lowest long-term opioid doses. Here, women showed a higher degree of opioid deprescription, but increased use of tramadol and neuromodulators, as well as an increased number of adverse events. Long-term deprescription was successful in half of the cases. Understanding sex and gender interaction plus a genetic impact could help to design more individualized strategies for opioid deprescription.

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Section: Demographic Clinical and Therapeutic Outcomesmentioning

confidence: 99%

Long-term deprescription in chronic pain and opioid use disorder patients: Pharmacogenetic and sex differences

Muriel¹,

Escorial

Margarit

et al. 2023

Acta Pharmaceutica

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“…Taking into account the increased incidence of rheumatic diseases in the elderly, it is crucial for healthcare providers to be aware of the potential treatment-related benefits and risks. Polypharmacy and polymorbidity are further potential challenges for pain management and rheumatoid disease treatment in elderly patients [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Indirect and Direct 65+ Patient Reporting of Non-Steroidal Anti-Inflammatory Drug-Induced Adverse Drug Reactions as a Source of Information on Polypharmacy and Polypharmacy-Related Risk

Sienkiewicz,

Burzyńska,

Rydlewska-Liszkowska

et al. 2023

Medicina

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Background and Objectives: Non-steroidal anti-inflammatory drugs (NSAIDs), which have anti-inflammatory and analgesic properties, are commonly used in the treatment of various, particularly frequent, as well as chronic, conditions in older patients. Due to common polypragmasia in these patients and a high risk of adverse drug reactions (ADRs) and drug interactions, pain management poses a therapeutic challenge. This study describes the importance of ADR reports in the identification of polypharmacy and the ensuing interactions. Materials and Methods: Both healthcare professionals (HPs) and non-healthcare professionals (non-HPs) reports collected in the EudraVigilance database of NSAIDs, including most commonly co-reported medications and reported reactions, were analysed and differences between HPs and non-HPs reports were identified. Results: In the analysed period and group, non-HPs reported more reactions but indicated fewer drugs as suspect or concomitant. The outcomes of our analysis indicate more HP engagement and more detailed reports of serious ADRs when compared to non-serious individual case safety reports (ICSRs) by non-HPs, which appeared more detailed. Such reactions as kidney failure and increased risk of bleeding are known adverse reactions to NSAIDs and common symptoms of their interactions, which were described in the available literature. They were much more frequently reported by HPs than by non-HPs. Non-HPs more frequently reported reactions that may have been considered less significant by HPs. Conclusions: The differences between healthcare professionals’ (HPs) and non-healthcare professionals’ (non-HPs) reports may result from the fact that the reports from patients and their caregivers require a professional medical diagnosis based on symptoms described by the patient or additional diagnostic tests. This means that when appropriately classified, medically verified, and statistically analysed, the data may provide new evidence for the risks of medication use or drug interactions.

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Pain Management

Gosch

2022

Senior Trauma Patients

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Polypharmacy and pain treatment

Cited by 14 publications

References 55 publications

Long-term deprescription in chronic pain and opioid use disorder patients: Pharmacogenetic and sex differences

Long-term deprescription in chronic pain and opioid use disorder patients: Pharmacogenetic and sex differences

Indirect and Direct 65+ Patient Reporting of Non-Steroidal Anti-Inflammatory Drug-Induced Adverse Drug Reactions as a Source of Information on Polypharmacy and Polypharmacy-Related Risk

Pain Management

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