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Updated: Jul 14, 2026

Determining Pain Detection and Tolerance Thresholds Using an Integrated, Multi-Modal Pain Task Battery
Published on: April 14, 2016
Pandemonium over painkillers persists
1Faculty of Health and Social Care, London South Bank University. david.cowan@lsbu.ac.uk
Abstract:
Chronic non-cancer pain remains under-treated. Five years ago it was highlighted that more research was needed into the safety and efficacy of NSAIDs and opioid drugs in older people (Cowan, 2002). Concerns remain over NSAID-induced pathology and now there are safety concerns over the continued use of supposedly safer COX-2 agents. There also remain concerns over the problematic use of opioids, including the potential for psychological and physical dependence. While more research is still needed to inform prescribing for older people, it is also apparent that we still need long-term studies of commonly used pain medications for the whole spectrum of age groups. Data derived from such studies would inform nurse prescribing.
Insights
Chronic pain management requires more research, especially for older adults. Long-term studies on common pain medications are essential for safe and effective nurse prescribing.
Area of Science:
- Pain Management
- Geriatric Pharmacology
- Pharmacovigilance
Background:
- Chronic non-cancer pain is inadequately treated, particularly in older populations.
- Previous research highlighted the need for safety and efficacy data on NSAIDs and opioids in the elderly.
- Ongoing concerns exist regarding NSAID-induced pathology and the safety of COX-2 inhibitors.
Purpose of the Study:
- To underscore the continuing need for research into pain medication safety and efficacy.
- To emphasize the necessity of long-term studies for commonly used pain medications across all age groups.
- To inform evidence-based nurse prescribing practices.
Main Methods:
- Review of existing literature and safety concerns regarding NSAIDs and opioids.
- Identification of research gaps in geriatric pain management.
- Analysis of the need for comprehensive, long-term medication studies.
Main Results:
- Safety concerns persist for NSAIDs, including COX-2 agents, and opioids due to dependence potential.
- Significant research gaps remain in understanding the long-term effects of pain medications in diverse age groups.
- Current data is insufficient to fully inform optimal prescribing for older adults.
Conclusions:
- Further long-term research on pain medications is crucial for all age groups, especially older adults.
- Addressing under-treatment of chronic pain requires robust safety and efficacy data.
- Improved data will enhance the quality and safety of nurse prescribing for pain management.
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