M Schuler1, D Razus, P Oster. 1. Diakonie-Krankenhaus, Speyererstr. 91-93, 68163, Mannheim, Deutschland. m.schuler@diako-mannheim.de
Abstract
BACKGROUND: Older patients, particularly those with multimorbidity, complain about many symptoms which also occur under analgesics (especially with opioids). The goals of the study were to quantify symptoms and discuss the relationships to analgesics, pain, multimorbidity, function, age and gender. PATIENTS AND METHODS: On admittance to geriatric hospital, 1700 consecutive inpatients were questioned about symptoms typically of side-effects of analgesics and pain. Additionally medication including analgesics, activities of daily living, orientation, age, gender and morbidity were recorded. RESULTS: Of the patients, 1,418 (mean age 80.9 years) could answer questions about symptoms. Disturbance of sleep (n=664, 46.8%), pain (n=609, 43.0%), low appetite (551, 37.4%), dizziness (482, 34%), tiredness (331, 19.7%), constipation (236, 16.6%) and problems of urination (213, 12.7%) were indicated most frequently. Univariate analysis showed the well known correlations of analgesics and symptoms to be dependent on dose and substances. However, using a multivariate model, analgesics lost the significance for the symptoms with some exceptions. Pain intensity, duration of pain and gender differences became more important. Vomiting, dry mouth, and problems with urination correlated with low levels of activities of daily living. Increasing morbidity and cognitive deficits were not important for many symptoms. CONCLUSIONS: Our results underline the difficult interpretation of symptoms as a side-effect of analgesic treatment in older patients. Pain and gender differences have to be considered. The recommendation to carefully record symptoms before analgesic treatment is supported by our results.
BACKGROUND: Older patients, particularly those with multimorbidity, complain about many symptoms which also occur under analgesics (especially with opioids). The goals of the study were to quantify symptoms and discuss the relationships to analgesics, pain, multimorbidity, function, age and gender. PATIENTS AND METHODS: On admittance to geriatric hospital, 1700 consecutive inpatients were questioned about symptoms typically of side-effects of analgesics and pain. Additionally medication including analgesics, activities of daily living, orientation, age, gender and morbidity were recorded. RESULTS: Of the patients, 1,418 (mean age 80.9 years) could answer questions about symptoms. Disturbance of sleep (n=664, 46.8%), pain (n=609, 43.0%), low appetite (551, 37.4%), dizziness (482, 34%), tiredness (331, 19.7%), constipation (236, 16.6%) and problems of urination (213, 12.7%) were indicated most frequently. Univariate analysis showed the well known correlations of analgesics and symptoms to be dependent on dose and substances. However, using a multivariate model, analgesics lost the significance for the symptoms with some exceptions. Pain intensity, duration of pain and gender differences became more important. Vomiting, dry mouth, and problems with urination correlated with low levels of activities of daily living. Increasing morbidity and cognitive deficits were not important for many symptoms. CONCLUSIONS: Our results underline the difficult interpretation of symptoms as a side-effect of analgesic treatment in older patients. Pain and gender differences have to be considered. The recommendation to carefully record symptoms before analgesic treatment is supported by our results.
Authors: Robert H Dworkin; Dennis C Turk; John T Farrar; Jennifer A Haythornthwaite; Mark P Jensen; Nathaniel P Katz; Robert D Kerns; Gerold Stucki; Robert R Allen; Nicholas Bellamy; Daniel B Carr; Julie Chandler; Penney Cowan; Raymond Dionne; Bradley S Galer; Sharon Hertz; Alejandro R Jadad; Lynn D Kramer; Donald C Manning; Susan Martin; Cynthia G McCormick; Michael P McDermott; Patrick McGrath; Steve Quessy; Bob A Rappaport; Wendye Robbins; James P Robinson; Margaret Rothman; Mike A Royal; Lee Simon; Joseph W Stauffer; Wendy Stein; Jane Tollett; Joachim Wernicke; James Witter Journal: Pain Date: 2005-01 Impact factor: 6.961
Authors: H D Basler; R Bloem; H R Casser; H U Gerbershagen; N Griessinger; U Hankemeier; S Hesselbarth; S Lautenbacher; T Nikolaus; W Richter; C Schröter; L Weiss Journal: Schmerz Date: 2001-06 Impact factor: 1.107