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Prescribing Analgesics to Older People: A Challenge for GPs

Background: Due to population aging, there is an increase in the prevalence of chronic diseases, and in particular musculoskeletal diseases. These trends are associated with an increased demand for prescription analgesics and an increased risk of polypharmacy and adverse medication reactions, which...

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Autores principales: Majnarić, Ljiljana Trtica, Wittlinger, Thomas, Stolnik, Dunja, Babič, František, Bosnić, Zvonimir, Rudan, Stjepan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7312581/
https://www.ncbi.nlm.nih.gov/pubmed/32516932
http://dx.doi.org/10.3390/ijerph17114017
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author Majnarić, Ljiljana Trtica
Wittlinger, Thomas
Stolnik, Dunja
Babič, František
Bosnić, Zvonimir
Rudan, Stjepan
author_facet Majnarić, Ljiljana Trtica
Wittlinger, Thomas
Stolnik, Dunja
Babič, František
Bosnić, Zvonimir
Rudan, Stjepan
author_sort Majnarić, Ljiljana Trtica
collection PubMed
description Background: Due to population aging, there is an increase in the prevalence of chronic diseases, and in particular musculoskeletal diseases. These trends are associated with an increased demand for prescription analgesics and an increased risk of polypharmacy and adverse medication reactions, which constitutes a challenge, especially for general practitioners (GPs), as the providers who are most responsible for the prescription policy. Objectives: To identify patterns of analgesics prescription for older people in the study area and explore associations between a long-term analgesic prescription and comorbidity patterns, as well as the prescription of psychotropic and other common medications in a continuous use. Methods: A retrospective study was conducted in 2015 in eastern Croatia. Patients were GP attenders ≥40 years old (N = 675), who were recruited during their appointments (consecutive patients). They were divided into two groups: those who have been continuously prescribed analgesics (N = 432) and those who have not (N = 243). Data from electronic health records were used to provide information about diagnoses of musculoskeletal and other chronic diseases, as well as prescription rates for analgesics and other medications. Exploratory methods and logistic regression models were used to analyse the data. Results: Analgesics have been continuously prescribed to 64% of the patients, mostly to those in the older age groups (50–79 years) and females, and they were indicated mainly for dorsalgia symptoms and arthrosis. Non-opioid analgesics were most common, with an increasing tendency to prescribe opioid analgesics to older patient groups aged 60–79 years. The study results indicate that there is a high rate of simultaneous prescription of analgesics and psychotropic medications, despite the intention of GPs to avoid prescribing psychotropic medications to patients who use any option with opioid analgesics. In general, receiving prescription analgesics does not exceed the prescription for chronic diseases over the rates that can be found in patients who do not receive prescription analgesics. Conclusion: Based on the analysis of comorbidities and parallel prescribing, the results of this study can improve GPs’ prescription and treatment strategies for musculoskeletal diseases and chronic pain conditions.
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spelling pubmed-73125812020-06-29 Prescribing Analgesics to Older People: A Challenge for GPs Majnarić, Ljiljana Trtica Wittlinger, Thomas Stolnik, Dunja Babič, František Bosnić, Zvonimir Rudan, Stjepan Int J Environ Res Public Health Article Background: Due to population aging, there is an increase in the prevalence of chronic diseases, and in particular musculoskeletal diseases. These trends are associated with an increased demand for prescription analgesics and an increased risk of polypharmacy and adverse medication reactions, which constitutes a challenge, especially for general practitioners (GPs), as the providers who are most responsible for the prescription policy. Objectives: To identify patterns of analgesics prescription for older people in the study area and explore associations between a long-term analgesic prescription and comorbidity patterns, as well as the prescription of psychotropic and other common medications in a continuous use. Methods: A retrospective study was conducted in 2015 in eastern Croatia. Patients were GP attenders ≥40 years old (N = 675), who were recruited during their appointments (consecutive patients). They were divided into two groups: those who have been continuously prescribed analgesics (N = 432) and those who have not (N = 243). Data from electronic health records were used to provide information about diagnoses of musculoskeletal and other chronic diseases, as well as prescription rates for analgesics and other medications. Exploratory methods and logistic regression models were used to analyse the data. Results: Analgesics have been continuously prescribed to 64% of the patients, mostly to those in the older age groups (50–79 years) and females, and they were indicated mainly for dorsalgia symptoms and arthrosis. Non-opioid analgesics were most common, with an increasing tendency to prescribe opioid analgesics to older patient groups aged 60–79 years. The study results indicate that there is a high rate of simultaneous prescription of analgesics and psychotropic medications, despite the intention of GPs to avoid prescribing psychotropic medications to patients who use any option with opioid analgesics. In general, receiving prescription analgesics does not exceed the prescription for chronic diseases over the rates that can be found in patients who do not receive prescription analgesics. Conclusion: Based on the analysis of comorbidities and parallel prescribing, the results of this study can improve GPs’ prescription and treatment strategies for musculoskeletal diseases and chronic pain conditions. MDPI 2020-06-05 2020-06 /pmc/articles/PMC7312581/ /pubmed/32516932 http://dx.doi.org/10.3390/ijerph17114017 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Majnarić, Ljiljana Trtica
Wittlinger, Thomas
Stolnik, Dunja
Babič, František
Bosnić, Zvonimir
Rudan, Stjepan
Prescribing Analgesics to Older People: A Challenge for GPs
title Prescribing Analgesics to Older People: A Challenge for GPs
title_full Prescribing Analgesics to Older People: A Challenge for GPs
title_fullStr Prescribing Analgesics to Older People: A Challenge for GPs
title_full_unstemmed Prescribing Analgesics to Older People: A Challenge for GPs
title_short Prescribing Analgesics to Older People: A Challenge for GPs
title_sort prescribing analgesics to older people: a challenge for gps
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7312581/
https://www.ncbi.nlm.nih.gov/pubmed/32516932
http://dx.doi.org/10.3390/ijerph17114017
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