Special Issues in the Management of Chronic Pain in Older Adults

Bruckenthal, Patricia; Reid, M. Carrington; Reisner, Lori

doi:10.1111/j.1526-4637.2009.00667.x

Cited by 53 publications

(56 citation statements)

References 92 publications

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“…I en norsk studie fant forskerne at 51 prosent av sykehjemspasientene rapporterte smerte, og av disse karakteriserte 45 prosent smerten som moderat eller sterk (12). Komplekse sykdomsbilder, underrapporterte symptomer og høy forekomst av kognitiv svikt gjør smertevurdering hos eldre vanskelig sammenliknet med annen voksen populasjon (13). Eldre som opplever smerte har ofte andre tilleggssymptomer som eksempel depresjon, angst, søvnforstyr-relser, dårlig matlyst eller vekttap (14).…”

Section: Bakgrunnunclassified

“…Hovedregelen når det gjelder dosering av analgetika hos eldre er «start low, go slow» (25). Farmakologiske behandlingstiltak er mest effektive i kombinasjon med ikke-farmakologiske tiltak for eksempel fysioterapi, treningsprogrammer, pasientutdanningsprogrammer, selvhjelp og kognitiv atferdsterapi (2,13,29). Det er sykepleierens ansvar å identifisere, administrere forordnet medikamentell smertebehandling, evaluere og dokumentere virkning og bivirkning, og målet er at pasienten oppnår smertelindring og opplever livskvalitet (30).…”

Section: Bakgrunnunclassified

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Smertekartlegging og medikamentell smertebehandling av eldre samtykkekompetente pasienter i sykehjem

Gran

Grov²,

Landmark

2013

Sykepleien

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Section: Bakgrunnunclassified

Smertekartlegging og medikamentell smertebehandling av eldre samtykkekompetente pasienter i sykehjem

Gran

Grov²,

Landmark

2013

Sykepleien

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“…The longterm use of NSAIDs should be avoided when possible because of their high frequency of adverse effects; e.g., risks of gastrointestinal bleeding and renal dysfunction which are significantly higher in older adults than in the younger population. The newer cyclooxygenese-2 (COX)-2 inhibitor NSAIDs are believed to be associated with a lower side effect profile in older adults [41]. COX-2 inhibitor NSAIDs has been linked to an increased incidence of acute coronary syndrome, although there is evidence that cardiovascular-related adverse events are not limited to the selective COX-2 inhibitors.…”

Section: Nonopioidsmentioning

confidence: 99%

“…Multidisciplinary pain programs that combine several modes of pharmacological and non-pharmacological treatment have demonstrated efficacy for the management of chronic pain in older adults. However, those programs appear to be not being used effectively, because older patients are less likely to be offered this treatment in pain management clinics, and receive fewer treatment options when attending such clinics due to inadequate representation [12,41].…”

Section: Management Of Chronic Musculoskeletal Pain In Older Adultsmentioning

confidence: 99%

“…Steroids, anticonvulsants, topical local anesthetics, and antidepressants are adjuvant agents. Depression/anxiety is often unnoticed in older patients and requires consideration when managing patients with pain [4,23,41]. The study of the relationship between depression and pain complaints in older patients has revealed that initial control of depression greatly facilitates pain management.…”

Section: Adjuvant Analgesicsmentioning

confidence: 99%

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Management of Chronic Musculoskeletal Pain in the Elderly: Dilemmas and Remedies

Edeer¹,

Tuna²

2012

Pain in Perspective

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Pain in Perspective 94percent of community dwelling adults aged 60 years or above have been found to experience pain and this number increases to 45-80% in the nursing home population with analgesics being used in 40% to 50% of residents [1,[13][14][15][16][17][18][19]. Brown et al report higher percentage and state that more than 90% of the elderly living in the community experienced pain within the past month [6]. Given the prevalence of chronic pain, its impact on health, and its costs, which approach $100 billion annually, chronic pain represents a major public health issue [20].While the existence of acute pain remains approximately the same across the adult life span, there is an age-related increase in the prevalence of chronic pain at least until the seventh decade of life [13,15]. Approximately 57% of older adults report experiencing pain for 1 or more years compared with less than 45% of younger people. Furthermore, long-term care data indicate that over 40% of patients, who were known to have pain at an initial assessment, had worsening or severe pain at the time of the second assessment 2-6 months later [21]. Chronic musculoskeletal painChronic musculoskeletal pain (CMP) is the most common, non-malignant disabling condition that affects at least one in four older people [22,23]. The most musculoskeletal pain in the joints of the upper and lower extremities, especially hips, knees, and hands, is associated with the degenerative changes of osteoarthritis. Older adults may also develop tendonitis and bursitis, as well as inflammatory joint and muscle disease [24]. The most common painful musculoskeletal conditions among older adults are osteoarthritis, low back pain, fibromyalgia, chronic shoulder pain, knee pain, myofascial pain syndrome and previous fracture sites [7,23,25].It is reported that the most common causes of pain identified in nursing home patients included arthritis and previous fractures. Arthritis alone affects well over 20 million Americans with an increase to 40 million expected by 2020. Twenty-nine percent of Medicare patients in nursing homes with a fracture in the prior 6 months suffer with daily pain [13]. Also surgical procedures are more frequently performed on older people. In the Medicare population in the United States for example, rates of total joint replacement surgery for patients with severe hip or knee osteoarthritis are more than doubled between 1988 and 1997. Over the same time period, rates of spine surgery in Medicare patients increased by 57% [23]. Chronic low back pain (CLBP) is one of the most common, poorly understood, and potentially disabling chronic pain condition s i n o l d e r a d u l t s [ 2 6 ] . M a n y o l d e r a d u l t s r e m a i n q u i t e functional despite CLBP, and because age-related co-morbidities often exist independently of pain, the unique impact of CLBP is unknown [27]. The Framingham Study (1992-1993 reported 63% of women pain in one or more regions, compared to 52% of men. Widespread CMP was more prevalent among women than men (15 versu...

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Current awareness in geriatric psychiatry

2010

Int J Geriat Psychiatry

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of geriatric psychiatry. Each bibliography is divided into 9 sections: 1 Reviews; 2 General; 3 Assessment; 4 Epidemiology; 5 Therapy; 6 Care; 7 Dementia; 8 Depression; 9 Psychology. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted

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Special Issues in the Management of Chronic Pain in Older Adults

Cited by 53 publications

References 92 publications

Smertekartlegging og medikamentell smertebehandling av eldre samtykkekompetente pasienter i sykehjem

Smertekartlegging og medikamentell smertebehandling av eldre samtykkekompetente pasienter i sykehjem

Management of Chronic Musculoskeletal Pain in the Elderly: Dilemmas and Remedies

Current awareness in geriatric psychiatry

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