Pitkala Kaisu H, Strandberg Timo E, Tilvis Reijo S
Helsinki University Hospital, Department of Medicine, Geriatric Clinic, Helsinki, Finland.
J Am Geriatr Soc. 2002 Nov;50(11):1861-5. doi: 10.1046/j.1532-5415.2002.50517.x.
To investigate use of prescribed analgesic drugs in relation to experience of joint or back pain in a home-dwelling older population, to study changes in the use of analgesic drugs over 10 years, and to investigate concomitant use of protective gastrointestinal drugs with prescribed analgesic drugs in 1999.
Cross-sectional mailed surveys 10 years apart.
Helsinki, Finland.
Random samples of older birth cohorts born in 1904, 1909, and 1914 in 1989 (n = 644) (n=644)-->, and of three separate cohorts born in 1914, 1919, and 1924 in 1999 (n = 3,000).
Use of various types of analgesic and protective gastrointestinal drugs, prescribed and over the counter. Experience of joint and back pain that interferes with daily functioning.
The response rate of home-dwelling older people was 83% in 1989 and 81% in 1999. Although the use of analgesic drugs as self-treatment increased from 28.5% to 41.4% during the 10 years, in 1999, only 35.5% to 38.2% of those suffering joint or back pain that impaired daily functioning had been prescribed an analgesic drug for regular use. Of those using prescribed medication, 57.5% were on nonsteroidal antiinflammatory drugs (NSAIDs), 20.9% acetaminophen, and 18.5% weak opiates. Only one-fifth of those individuals taking NSAIDs were on a concomitant gastroprotective drug.
Pain is markedly undertreated in community-dwelling older people, which may have serious implications for their well-being and functioning. Although we noted a tendency for safety in the use of prescribed analgesic drugs, a significant effort must sill be made to implement evidence-based practice. Self-treatment of pain has increased in 1 decade, which may reduce the overall safety of analgesic drug use among older people.
调查居家老年人群中处方镇痛药的使用情况与关节或背痛经历之间的关系，研究10年间镇痛药使用情况的变化，并调查1999年处方镇痛药与保护性胃肠道药物的联合使用情况。
相隔10年的横断面邮寄调查。
芬兰赫尔辛基。
1989年随机抽取的1904年、1909年和1914年出生的老年队列样本（n = 644），以及1999年随机抽取的分别出生于1914年、1919年和1924年的三个独立队列样本（n = 3000）。
处方和非处方的各类镇痛药及保护性胃肠道药物的使用情况。影响日常功能的关节和背痛经历。
1989年居家老年人的回复率为83%，1999年为81%。尽管10年间作为自我治疗的镇痛药使用从28.5%增加到了41.4%，但在1999年，只有35.5%至38.2%日常功能受关节或背痛影响的患者被开具了常规使用的镇痛药。在使用处方药物的患者中，57.5%使用非甾体抗炎药（NSAIDs），20.9%使用对乙酰氨基酚，18.5%使用弱阿片类药物。服用NSAIDs的患者中只有五分之一同时服用了胃肠道保护药物。
社区居家老年人的疼痛治疗明显不足，这可能对他们的健康和功能产生严重影响。尽管我们注意到处方镇痛药使用有安全趋势，但仍必须做出重大努力以实施循证实践。疼痛的自我治疗在10年中有所增加，这可能会降低老年人镇痛药使用的总体安全性。
