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Treating persistent pain in the elderly: how do we proceed?

Lauren Corrado-McKeon1, Maha Saad, Tanveer Mir

  • 1Department of Pharmacy Services, Long Island Jewish Medical Center, New Hyde Park, NY, USA. lcorrado@nshs.edu

The Consultant Pharmacist : the Journal of the American Society of Consultant Pharmacists
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Summary
This summary is machine-generated.

This study improved pain assessment tools for older adults but found no significant changes in NSAID/coxib use or opioid management. Further education is needed for safe persistent pain management in the elderly.

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Area of Science:

  • Geriatric Medicine
  • Pharmacology
  • Pain Management

Background:

  • Persistent pain is common in older adults.
  • The American Geriatrics Society (AGS) provides guidelines for pharmacological pain management.
  • Effective management is crucial for quality of life in elderly patients.

Purpose of the Study:

  • To evaluate a performance improvement initiative for persistent pain management in older adults.
  • To assess the impact of education on healthcare provider adherence to AGS guidelines.
  • To identify areas for improvement in prescribing NSAIDs, coxibs, and opioids, and managing adverse effects.

Main Methods:

  • A three-phase study was conducted in a tertiary care teaching hospital.
  • Healthcare providers received education on AGS guidelines for persistent pain management.
  • Outcomes included NSAID/coxib use, pain assessment tool utilization, opioid selection, and adverse event prevention.

Main Results:

  • Improved use of pain assessment tools in cognitively impaired older adults post-education.
  • A trend towards improved appropriate use of NSAIDs and coxibs was observed.
  • No significant changes noted in opioid frequency, combination therapy, or constipation prevention.

Conclusions:

  • Performance improvement initiatives can enhance specific aspects of pain management, like assessment tools.
  • Further education is necessary to achieve comprehensive adherence to AGS guidelines for persistent pain in older adults.
  • Safe and effective pharmacological management of persistent pain requires ongoing professional development.