School of Physiotherapy, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland.
Data Science Centre, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
BMC Musculoskelet Disord. 2024 Oct 2;25(1):773. doi: 10.1186/s12891-024-07854-8.
This study aimed to identify and describe links between pain medication use and self-reported pain among people aged ≥ 50 years with osteoarthritis (OA) in an Irish population, and to examine the relationships between pain, medication usage and socioeconomic and clinical characteristics.
Secondary data analysis of wave 1 cross-sectional data from The Irish Longitudinal Study on Ageing (TILDA) was undertaken of 1042 people with self-reported doctor-diagnosed OA. We examined use of medications typically included in OA clinical guidelines, including non-opioid analgesics (e.g. paracetamol), topical and oral non-steroidal anti-inflammatory drugs (NSAIDs), opioids and nutraceuticals. Latent Class Analysis (LCA) was used to identify underlying clinical subgroups based on medication usage patterns, and self-reported pain severity. Multinomial logistic regression was used to explore sociodemographic and clinical characteristic links to latent class membership.
A total of 358 (34.4%) of the 1042 people in this analysis were taking pain medications including oral NSAIDs (17.5%), analgesics (11.4%) and opioids (8.7%). Nutraceutical (glucosamine/chondroitin) use was reported by 8.6% and topical NSAID use reported by 1.4%. Three latent classes were identified: (1) Low medication use/no pain (n = 382, 37%), (2) low medication use/moderate pain (n = 523, 50%) and (3) moderate medication use/high pain (n = 137, 13%). Poorer self-rated health and greater sleep disturbance were associated with classes 2 and 3; depressive symptoms and female gender were associated with class 2, and retirement associated with class 3.
Whilst pain medication use varied with pain severity, different medication types reported broadly aligned with OA guidelines. The two subgroups exhibiting higher pain levels demonstrated poorer self-rated health and greater sleep disturbance.
本研究旨在识别和描述爱尔兰 50 岁及以上骨关节炎（OA）患者疼痛药物使用与自我报告疼痛之间的联系，并研究疼痛、药物使用与社会经济和临床特征之间的关系。
对爱尔兰老龄化纵向研究（TILDA）第 1 波横断面数据进行二次数据分析，共纳入 1042 名自我报告经医生诊断为 OA 的患者。我们检查了通常包含在 OA 临床指南中的药物使用情况，包括非阿片类镇痛药（如对乙酰氨基酚）、局部和口服非甾体抗炎药（NSAIDs）、阿片类药物和营养药物。潜在类别分析（LCA）用于根据药物使用模式和自我报告的疼痛严重程度确定潜在的临床亚组。使用多项逻辑回归探索社会人口统计学和临床特征与潜在类别成员资格的关系。
在这项分析中，共有 358 人（34.4%）正在服用止痛药，包括口服 NSAIDs（17.5%）、镇痛药（11.4%）和阿片类药物（8.7%）。报告使用营养药物（氨基葡萄糖/软骨素）的占 8.6%，局部 NSAIDs 占 1.4%。确定了三个潜在类别：（1）低药物使用/无疼痛（n=382，37%），（2）低药物使用/中度疼痛（n=523，50%）和（3）中度药物使用/高度疼痛（n=137，13%）。自我报告的健康状况较差和睡眠障碍较大与类别 2 和 3 相关；抑郁症状和女性与类别 2 相关，退休与类别 3 相关。
尽管疼痛药物的使用因疼痛严重程度而异，但报告的不同药物类型大致符合 OA 指南。表现出更高疼痛水平的两个亚组自我报告的健康状况较差，睡眠障碍较大。
