Rapo-Pylkkö Susanna, Haanpää Maija, Liira Helena
Kirkkonummi Health Center, Virkatie 1, 02400, Kirkkonummi, Finland.
Unit of Primary Health Care, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
Drugs Aging. 2015 Sep;32(9):737-42. doi: 10.1007/s40266-015-0294-5.
Neuropathic pain is more common among older people than in the general population, and the efficacy of medical treatment often remains unsatisfactory.
The aim of this study was to assess the presence, diagnostic certainty, etiology and treatment of neuropathic pain in community-dwelling older people with chronic pain.
Independently living older people aged 75, 80 and 85 years subject to communal preventive home visits with chronic pain were invited to a clinical pain examination by a geriatrician.
Overall, 106 patients consented to participate in the clinical study. Neuropathic pain was diagnosed in 51 (48%) patients, with 75% of pain states definite and 25% probable neuropathic pain. The most common etiology was degenerative disease of the spinal column causing radiculopathy. At the study visit, 11 patients (22% of neuropathic pain patients) were receiving medication that was demonstrated to be effective against neuropathic pain. The geriatrician recommended a trial of a new medicine for 17 patients, but only six continued the medication going forward.
Neuropathic pain was surprisingly common in our cohort. Finding effective pain medication is challenging due to comorbidities, possible side effects, and vulnerability in older age. Other pain management methods should be considered.
神经性疼痛在老年人中比在普通人群中更为常见，并且药物治疗的效果往往仍不尽人意。
本研究的目的是评估社区居住的慢性疼痛老年人中神经性疼痛的存在、诊断确定性、病因及治疗情况。
邀请年龄分别为75岁、80岁和85岁、独立生活且接受社区预防性家访时有慢性疼痛的老年人接受老年病科医生的临床疼痛检查。
总体而言，106名患者同意参与临床研究。51名（48%）患者被诊断为神经性疼痛，其中75%的疼痛状态为确诊的神经性疼痛，25%为可能的神经性疼痛。最常见的病因是导致神经根病的脊柱退行性疾病。在研究访视时，11名患者（占神经性疼痛患者的22%）正在服用被证明对神经性疼痛有效的药物。老年病科医生建议17名患者试用一种新药，但只有6名患者继续服用该药物。
在我们的队列中，神经性疼痛出人意料地常见。由于合并症、可能的副作用以及老年人的脆弱性，找到有效的止痛药物具有挑战性。应考虑其他疼痛管理方法。
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