Managing chronic pain in older people

Management of pain in older people should follow the biopsychosocial model, addressing the heterogeneity in their physiological changes, psychological and cognitive aspects, and impact on their social interactions. When deciding on pharmacological treatment, special attention should be given to the side effect profile, drug-drug and drug-disease interactions, as well as route and timing of medication administration. The principle of 'start low, go slow' should be followed, and regular reviews of drug effectiveness and tolerability are required. With the adjunct of non-pharmacological interventions, the treatment plan should be tailored to individual needs, with the aim to ameliorate the burden of pain while preserving quality of life.