Clinical approach to chronic pain in geriatric patients

Authors

  • Fernando Gabriel Medina Andaluz
  • Joselyn Vanessa Flores Fiallos
  • Sofía Belén Quisiguiña Cárdenas
  • Marlon Alexander Chávez Solano
  • José Rolando Chimbolema Chimbolema
  • Hugo Patricio Roldán Simbaña
  • Elizabeth Sánchez Andrango
  • Janneth Karina Morales Guaminga
  • Gissela Paulina Cofre Santo

Abstract

Chronic pain (CP) is a highly frequent clinical problem in the elderly population, which entails severe consequences for overall wellbeing, functionality and Independence, and quality of life. Almost invariably, CP causes and reinforces added conditions, such as sleep disorders, musculoskeletal alterations, reduced mobility, falls, malnutrition, neurocognitive decline, depression and other mental disorders, and polypharmacy. The work and financial burden of CP in geriatric patients on public health systems is equally aggravating, estimated in several thousands of dollars per patient annually, fundamentally attributed to hospitalizations, paramedical care, medications, and medical consultations. These expenses have shown a rapid upwards trend in recent years. In this scenario, clear, precise and quick medical intervention is necessary, with an organized focus. Interdisciplinary word shines in this respect as an essential element, along with the integration of the family and other caretakers. Thus, this article reviews the clinical approach to CP in geriatric patients, including psychosocial and pharmacologic interventions.

Keywords: Chronic pain, geriatric, aging, pain management.

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References

Treede R-D, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. A classification of chronic pain for ICD-11. Pain. 2015;156(6):1003-7.

Dahlhamer J, Lucas J, Zelaya, C, Nahin R, Mackey S, DeBar L, et al. Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States, 2016. MMWR Morb Mortal Wkly Rep. 2018;67(36):1001-6.

International Pain Summit of the International Association for the Study Of Pain. Declaration of Montréal: Declaration That Access to Pain Management Is a Fundamental Human Right. J Pain Palliat Care Pharmacother. 2011;25(1):29-31.

Noroozian M, Raeesi S, Hashemi R, Khedmat L, Vahabi Z. Pain: The Neglect Issue in Old People’s Life. Open Access Maced J Med Sci. 2018;6(9):1773-8.

Dahan A, van Velzen M, Niesters M. Comorbidities and the Complexities of Chronic Pain. Anesthesiology. 2014;121(4):675-7.

Lazkani A, Delespierre T, Bauduceau B, Pasquier F, Bertin P, Berrut G, et al. Healthcare costs associated with elderly chronic pain patients in primary care. Eur J Clin Pharmacol. 2015;71(8):939-47.

Makris UE, Higashi RT, Marks EG, Fraenkel L, Sale JEM, Gill TM, et al. Ageism, negative attitudes, and competing co-morbidities – why older adults may not seek care for restricting back pain: a qualitative study. BMC Geriatr. 2015;15(1):39.

Aujoulat I, Jacquemin P, Darras E, Rietzschel E, Wens J, Hermans M, et al. Factors associated with clinical inertia: an integrative review. Adv Med Educ Pract. 2014;5:141-7.

Kress H-G, Ahlbeck K, Aldington D, Alon E, Coaccioli S, Coluzzi F, et al. Managing chronic pain in elderly patients requires a CHANGE of approach. Curr Med Res Opin. 2014;30(6):1153-64.

Liberman O, Freud T, Peleg R, Keren A, Press Y. Chronic pain and geriatric syndromes in community-dwelling patients aged ≥65 years. J Pain Res. 2018;Volume 11:1171-80.

Breivik H, Eisenberg E, O’Brien T. The individual and societal burden of chronic pain in Europe: the case for strategic prioritisation and action to improve knowledge and availability of appropriate care. BMC Public Health. 2013;13(1):1229.

Kim Y-S, Park J-M, Moon Y-S, Han S-H. Assessment of pain in the elderly: A literature review. Natl Med J India. 2017;30(4):203-7.

Jones J, Sim T, Hughes J. Pain Assessment of Elderly Patients with Cognitive Impairment in the Emergency Department: Implications for Pain Management—A Narrative Review of Current Practices. Pharm Basel. 2017;5(2):30.

Tang M, Wollsen M, Aagaard L. Pain monitoring and medication assessment in elderly nursing home residents with dementia. J Res Pharm Pract. 2016;5(2):126-31.

Das Ra, Kumar Sg, Roy G. Morbidity pattern and its relation to functional limitations among old age rural population in Kerala, India. J Fam Med Prim Care. 2017;6(2):301-4.

van Kooten J, Delwel S, Binnekade TT, Smalbrugge M, van der Wouden JC, Perez RS, et al. Pain in dementia: prevalence and associated factors: protocol of a multidisciplinary study. BMC Geriatr. 2015;15(1):29.

Elsawy B, Higgins KE. The Geriatric Assessment. Am Fam Physician. 2011;83(1):48-56.

Makris UE, Abrams RC, Gurland B, Reid MC. Management of Persistent Pain in the Older Patient: A Clinical Review. JAMA. 2014;312(8):825–836.

Azevedo LF, Costa-Pereira A, Mendonça L, Dias CC, Castro-Lopes JM. Chronic pain and health services utilization: is there overuse of diagnostic tests and inequalities in nonpharmacologic treatment methods utilization? Med Care. 2013;51(10):859-69.

Dansie EJ, Turk DC. Assessment of patients with chronic pain. Br J Anaesth. 2013;111(1):19-25.

Morlion B. Pharmacotherapy of low back pain: targeting nociceptive and neuropathic pain components. Curr Med Res Opin. 2011;27(1):11-33.

Booker SQ, Herr KA. Assessment and Measurement of Pain in Adults in Later Life. Clin Geriatr Med. 2016;32(4):677-92.

Wong AYL, Forss KS, Jakobsson J, Schoeb V, Kumlien C, Borglin G. Older adult’s experience of chronic low back pain and its implications on their daily life: Study protocol of a systematic review of qualitative research. Syst Rev. 2018;7(1):81.

Riffin C, Fried T, Pillemer K. Impact of Pain on Family Members and Caregivers of Geriatric Patients. Clin Geriatr Med. 2016;32(4):663-75.

van Kempen JA, Robben SH, Zuidema SU, Rikkert MGO, Melis RJ, Schers HJ. Home visits for frail older people: a qualitative study on the needs and preferences of frail older people and their informal caregivers. Br J Gen Pract. 2012;62(601):e554-60.

Keefe FJ, Porter L, Somers T, Shelby R, Wren AV. Psychosocial interventions for managing pain in older adults: outcomes and clinical implications. Br J Anaesth. 2013;111(1):89-94.

Du S, Yuan C, Xiao X, Chu J, Qiu Y, Qian H. Self-management programs for chronic musculoskeletal pain conditions: a systematic review and meta-analysis. Patient Educ Couns. 2011;85(3):e299-310.

Marengoni A, Nobili A, Onder G. Best Practices for Drug Prescribing in Older Adults: A Call for Action. Drugs Aging. 2015;32(11):887-90.

American Geriatrics Society Panel on Pharmacological Management of Persistent Pain in Older Persons. Pharmacological management of persistent pain in older persons. J Am Geriatr Soc. 2009;57(8):1331-46.

Trelle S, Reichenbach S, Wandel S, Hildebrand P, Tschannen B, Villiger PM, et al. Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis. BMJ. 2011;342:c7086-c7086.

Arnstein PM. Evolution of Topical NSAIDs in the Guidelines for Treatment of Osteoarthritis in Elderly Patients. Drugs Aging. 2012;29(7):523-31.

Reid MC, Henderson CR, Papaleontiou M, Amanfo L, Olkhovskaya Y, Moore AA, et al. Characteristics of older adults receiving opioids in primary care: treatment duration and outcomes. Pain Med Malden Mass. 2010;11(7):1063-71.

Stephan BC, Parsa FD. Avoiding Opioids and Their Harmful Side Effects in the Postoperative Patient: Exogenous Opioids, Endogenous Endorphins, Wellness, Mood, and Their Relation to Postoperative Pain. Hawaii J Med Public Health J Asia Pac Med Public Health. 2016;75(3):63-7.

Lester P, Remolana R, Sandhu S, Scott J. Road Map for Opioid Management in the Inpatient Setting: A Structured Approach to Opioid Selection and Titration. MedEdPORTAL Publ. 2016;12:10470.

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Published

2023-03-30

How to Cite

Medina Andaluz, F. G. ., Flores Fiallos, J. V. ., Quisiguiña Cárdenas, S. B. ., Chávez Solano, M. A. ., Chimbolema Chimbolema, J. R. ., Roldán Simbaña, H. P. ., Sánchez Andrango, E. ., Morales Guaminga, J. K. ., & Cofre Santo, G. P. . (2023). Clinical approach to chronic pain in geriatric patients. AVFT – Archivos Venezolanos De Farmacología Y Terapéutica, 40(5). Retrieved from http://saber.ucv.ve/ojs/index.php/rev_aavft/article/view/25864

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Vol. 40 No. 5 (2021): AVFT Archivos Venezolanos de Farmacología y Terapéutica

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Artículos

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