Schuler M, Oster P
Bethanien-Krankenhaus, Geriatrisches Zentrum an der Universität Heidelberg.
Schmerz. 2005 Aug;19(4):302-7. doi: 10.1007/s00482-004-0377-4.
During the previous 20 years the prescription of opioids for medical use has increased steadily. Patients and professionals have great reservations about the use of opioids in the elderly. The aim of this study was to describe the changes in analgesic therapy in a geriatric clinic during the previous 10 years.
The quality and quantity of prescriptions for opioids as well as the costs of the analgesic therapy in a large geriatric clinic between 1994 and 2003 were analyzed.
The use of opioids increased steadily from 0.72 mg per day and patient in 1994 to 9.50 mg in 2003 (1320%). The introduction of sustained release tilidine/naloxone and tramadol led to a change of the prescribed forms but only to a slight increase in the total consumption of these drugs. In 1994 the average daily cost of analgesic therapy was 15 cents per patient compared with 46 cents in 2003. The percentage of analgesics in the pharmacological budget increased from 5.6 to 10.8%.
Dealing with opioids should be a part of the training program for all members of the geriatric team. Analgesics have come to play an important role in the pharmacological budget at least in this geriatric clinic.
