Kennedy Mary-Claire, Cousins Grainne, Henman Martin C
School of Healthcare, Baines Wing, University of Leeds, Leeds, LS29JT, UK.
School of Pharmacy, Royal College of Surgeons in Ireland, St. Stephens Green, Dublin, Ireland.
Int J Clin Pharm. 2017 Aug;39(4):798-807. doi: 10.1007/s11096-017-0466-y. Epub 2017 May 4.
Background Analgesics are used in the management of chronic non-malignant pain (CNMP), a condition which is highly prevalent among older adults. CNMP may not only be physically distressing but also complicated by psychosocial and economic factors. An individual's perception and use of analgesics may be influenced by a range of factors such as perceptions of risk or benefits, ability to purchase medication or access to non-pharmacological therapies or specialist care. Objective The aim of this study was to describe the perceptions and experiences of analgesics by ageing and elderly individuals with CNMP and identify factors that influence their use. Setting Telephone interviews with 28 members of Chronic Pain Ireland aged ≥50. Method In-depth semi-structured interviews; audio-recorded, transcribed verbatim, and thematically analysed. Main outcome measure Experiences and perceptions of ageing and elderly individuals with CNMP taking analgesics. Results A combination of factors specific to the patient and arising from outside influences informed perceptions and experiences of analgesics. Pain severity, perceived efficacy of analgesics, occurrence of adverse-effects and concerns about addiction/dependence were identified as internal factors influencing medication use. External factors included views of family members, access to specialised care and the individual's interaction with healthcare professionals (HCPs). Conclusion Individuals with CNMP regard analgesics as an important method for managing pain and are relied upon when other interventions are difficult to access. HCPs in primary care, who are the main point of contact for patients, need to take into account the various factors that may influence analgesic use when consulting with this patient group.
背景 镇痛药用于慢性非恶性疼痛（CNMP）的治疗，这种疾病在老年人中非常普遍。CNMP不仅会给身体带来痛苦，还会受到心理社会和经济因素的影响。个人对镇痛药的认知和使用可能受到一系列因素的影响，如对风险或益处的认知、购买药物的能力、获得非药物治疗或专科护理的机会。目的 本研究的目的是描述患有CNMP的老年人对镇痛药的认知和体验，并确定影响其使用的因素。研究对象 对爱尔兰慢性疼痛协会28名年龄≥50岁的成员进行电话访谈。方法 进行深入的半结构化访谈；进行录音、逐字转录并进行主题分析。主要观察指标 患有CNMP的老年人服用镇痛药的体验和认知。结果 患者特有的因素和外部影响因素共同影响了对镇痛药的认知和体验。疼痛严重程度、镇痛药的感知疗效、不良反应的发生以及对成瘾/依赖的担忧被确定为影响药物使用的内部因素。外部因素包括家庭成员的看法、获得专科护理的机会以及个人与医疗保健专业人员（HCPs）的互动。结论 患有CNMP的个体将镇痛药视为管理疼痛的重要方法，并且在难以获得其他干预措施时会依赖镇痛药。初级保健中的HCPs是患者的主要接触点，在与该患者群体咨询时需要考虑可能影响镇痛药使用的各种因素。
