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Deficits in pain medication in older adults with chronic pain receiving home care: A cross-sectional study in Germany

OBJECTIVE: To analyze the pattern and appropriateness of pain medications in older adults receiving home care. METHODS: We performed a prospective cross-sectional study in patients ≥65 years old having chronic pain and receiving home care in Berlin, Germany. Data on prescribed pain medications were...

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Autores principales: Schneider, Juliana, Algharably, Engi, Budnick, Andrea, Wenzel, Arlett, Dräger, Dagmar, Kreutz, Reinhold
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034806/
https://www.ncbi.nlm.nih.gov/pubmed/32084203
http://dx.doi.org/10.1371/journal.pone.0229229
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author Schneider, Juliana
Algharably, Engi
Budnick, Andrea
Wenzel, Arlett
Dräger, Dagmar
Kreutz, Reinhold
author_facet Schneider, Juliana
Algharably, Engi
Budnick, Andrea
Wenzel, Arlett
Dräger, Dagmar
Kreutz, Reinhold
author_sort Schneider, Juliana
collection PubMed
description OBJECTIVE: To analyze the pattern and appropriateness of pain medications in older adults receiving home care. METHODS: We performed a prospective cross-sectional study in patients ≥65 years old having chronic pain and receiving home care in Berlin, Germany. Data on prescribed pain medications were collected using self-reported information, nursing documents, and medication plans during interviews at home. Pain intensity was determined with the numeric rating scale (NRS) and the Pain Assessment In Advanced dementia (PAINAD) scale. The Pain Medication Appropriateness Scale score (S(PMAS)) was applied to evaluate inappropriateness (i.e. a score ≤67) of pain medication. RESULTS: Overall 322 patients with a mean age of 82.1 ± 7.4 years (71.4% females) were evaluated. The average pain intensity scores during the last 24 hours were 5.3 ± 2.1 and 2.3 ± 2.3 on NRS and PAINAD scale (range 0–10, respectively). Sixty (18.6%) patients did not receive any pain medication. Among the treated patients, dipyrone was the most frequently prescribed analgesic (71.4%), while 50.8% and 19.1% received systemic treatment with opioids and non-steroidal anti-inflammatory drugs, respectively. The observed median S(PMAS) was 47.6 (range 0–100) with 58 (18.0%) of patients achieving appropriate values. Half of the patients were treated with scheduled, while 29.9% were only treated with on-demand medications. Cognitive status had no effect on appropriateness of pain treatment. CONCLUSIONS: We observed substantial deficits in dosing patterns and appropriateness of pain medication in older adults with pain receiving home care. This applied to both patients with and without severe cognitive impairment.
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spelling pubmed-70348062020-02-27 Deficits in pain medication in older adults with chronic pain receiving home care: A cross-sectional study in Germany Schneider, Juliana Algharably, Engi Budnick, Andrea Wenzel, Arlett Dräger, Dagmar Kreutz, Reinhold PLoS One Research Article OBJECTIVE: To analyze the pattern and appropriateness of pain medications in older adults receiving home care. METHODS: We performed a prospective cross-sectional study in patients ≥65 years old having chronic pain and receiving home care in Berlin, Germany. Data on prescribed pain medications were collected using self-reported information, nursing documents, and medication plans during interviews at home. Pain intensity was determined with the numeric rating scale (NRS) and the Pain Assessment In Advanced dementia (PAINAD) scale. The Pain Medication Appropriateness Scale score (S(PMAS)) was applied to evaluate inappropriateness (i.e. a score ≤67) of pain medication. RESULTS: Overall 322 patients with a mean age of 82.1 ± 7.4 years (71.4% females) were evaluated. The average pain intensity scores during the last 24 hours were 5.3 ± 2.1 and 2.3 ± 2.3 on NRS and PAINAD scale (range 0–10, respectively). Sixty (18.6%) patients did not receive any pain medication. Among the treated patients, dipyrone was the most frequently prescribed analgesic (71.4%), while 50.8% and 19.1% received systemic treatment with opioids and non-steroidal anti-inflammatory drugs, respectively. The observed median S(PMAS) was 47.6 (range 0–100) with 58 (18.0%) of patients achieving appropriate values. Half of the patients were treated with scheduled, while 29.9% were only treated with on-demand medications. Cognitive status had no effect on appropriateness of pain treatment. CONCLUSIONS: We observed substantial deficits in dosing patterns and appropriateness of pain medication in older adults with pain receiving home care. This applied to both patients with and without severe cognitive impairment. Public Library of Science 2020-02-21 /pmc/articles/PMC7034806/ /pubmed/32084203 http://dx.doi.org/10.1371/journal.pone.0229229 Text en © 2020 Schneider et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Schneider, Juliana
Algharably, Engi
Budnick, Andrea
Wenzel, Arlett
Dräger, Dagmar
Kreutz, Reinhold
Deficits in pain medication in older adults with chronic pain receiving home care: A cross-sectional study in Germany
title Deficits in pain medication in older adults with chronic pain receiving home care: A cross-sectional study in Germany
title_full Deficits in pain medication in older adults with chronic pain receiving home care: A cross-sectional study in Germany
title_fullStr Deficits in pain medication in older adults with chronic pain receiving home care: A cross-sectional study in Germany
title_full_unstemmed Deficits in pain medication in older adults with chronic pain receiving home care: A cross-sectional study in Germany
title_short Deficits in pain medication in older adults with chronic pain receiving home care: A cross-sectional study in Germany
title_sort deficits in pain medication in older adults with chronic pain receiving home care: a cross-sectional study in germany
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034806/
https://www.ncbi.nlm.nih.gov/pubmed/32084203
http://dx.doi.org/10.1371/journal.pone.0229229
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