The following information is reproduced with the permission of
The National Council on the Aging.
Pain Is Undertreated in Seniors, Experts Say
-- Safer, more effective pain management could improve quality of life --
Safer, more effective therapy could improve the quality of life of
older Americans who take pain medication. This conclusion was shared by pain
specialists and experts on aging who reviewed
findings of a survey released in
June 1997 by The National Council on the Aging, Inc. (NCOA). The survey,
conducted by Louis Harris & Associates on behalf of NCOA, examined how pain
and its treatment affect the lives of the nearly one in five Americans over age
60 who regularly take pain medication for arthritis and other chronic pain
While the majority of those surveyed believe pain drugs are effective, two in
three seniors who take them say pain still prevents them from doing routine
tasks and hobbies. Activities most likely to be affected include walking,
housekeeping, gardening, and socializing. "Not only does pain impair
quality of life for many older people, but it can also limit their ability to
function independently," said Donna Wagner, Ph.D., Vice President,
Research and Demonstrations, NCOA.
A tendency among seniors to settle for even a small degree of pain relief may
explain why most seniors say medication is effective even though pain still
interferes with their lifestyle, according to Betty Ferrell, Ph.D., F.A.A.N.,
Associate Research Scientist, City of Hope National Medical Center in Los
Angeles, CA. "For many, any level of pain relief is better than none at
all." Dr. Ferrell noted that older Americans surveyed were more likely to
take weaker non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen,
than more potent analgesics including propoxyphenes, codeine derivatives, and
other opioids. "The wide use of NSAIDs reported in the survey reflects an
overall pattern of undertreating pain in the elderly," she said.
Dr. Ferrell is also concerned about findings that show seniors typically take
NSAIDs for long periods of time. "Older Americans typically take
prescription NSAIDs for six months or more despite regulatory warnings that
risk increases after just three months. Large numbers of seniors also take the
lower-strength, non-prescription NSAIDs on average for five years. These types
of NSAIDs are known to cause serious gastrointestinal side effects."
Other types of side effects caused by pain medications also pose particular
risk to seniors. "Drowsiness and dizziness are common side effects of pain
medications," said Dorothy Baker, Ph.D., Associate Research Scientist,
Program on Aging, Yale University School of Medicine. "These increase the
risk for falls and hip fractures, a leading reason for premature entry to
The increasing participation of older Americans in managed care plans may also
play a role in less than optimal chronic pain management for seniors.
"Older people are likely to see at least three different doctors for pain
care, but the vast majority see primary care physicians. They only rarely see
rheumatologists or other professionals who specialize in treating chronic
pain," Dr. Wagner said. "Managed care plans may limit their access to
Dr. Wagner believes that better communication with doctors is key to improved
chronic pain management for seniors. "While most older Americans surveyed
said their physician or pharmacist had talked to them about the side effects of
pain drugs, only half said their physician or pharmacist had discussed possible
drug interactions with other medications they take. Understanding potential
drug interactions is critical for older people, because they typically take up
to seven different medications a day. Seniors should make sure doctors and
pharmacists are aware of all the medications they take, and contact doctors
immediately if they notice side effects or other problems that might be related
to their pain drug."
The Pain & Older Americans Survey is a survey of national cross-section of
500 randomly selected Americans over age 60 who regularly take pain medication
that was prescribed or recommended by their doctor for pain conditions lasting
six months or longer. It was underwritten by an educational grant
from Ortho-McNeil Pharmaceutical.
© Ortho-McNeil Pharmaceutical 1995-2003.
All rights reserved.
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