Literature DB >> 21992521

Analgesic use for knee and hip osteoarthritis in community-dwelling elders.

Zachary A Marcum1, Subashan Perera, Julie M Donohue, Robert M Boudreau, Anne B Newman, Christine M Ruby, Stephanie A Studenski, C Kent Kwoh, Eleanor M Simonsick, Doug C Bauer, Suzanne Satterfield, Joseph T Hanlon.   

Abstract

OBJECTIVE: To examine the prevalence and correlates of non-opioid and opioid analgesic use and descriptively evaluate potential undertreatment in a sample of community-dwelling elders with symptomatic knee and/or hip osteoarthritis (OA).
DESIGN: Cross-sectional.
SETTING: Health, Aging, and Body Composition Study. PATIENTS: Six hundred and fifty-two participants attending the year 6 visit (2002-03) with symptomatic knee and/or hip OA. OUTCOME MEASURES: Analgesic use was defined as taking ≥1 non-opioid and/or ≥1 opioid receptor agonist. Non-opioid and opioid doses were standardized across all agents by dividing the daily dose used by the minimum effective analgesic daily dose. Inadequate pain control was defined as severe/extreme OA pain in the past 30 days from a modified Western Ontario and McMaster Universities Osteoarthritis Index.
RESULTS: Just over half (51.4%) reported taking at least one non-opioid analgesic and approximately 10% was taking an opioid, most (88.5%) of whom also took a non-opioid. One in five participants (19.3%) had inadequate pain control, 39% of whom were using <1 standardized daily dose of either a non-opioid or opioid analgesic. In adjusted analyses, severe/extreme OA pain was significantly associated with both non-opioid (adjusted odds ratio [AOR] = 2.44; 95% confidence interval [95% CI] = 1.49-3.99) and opioid (AOR = 2.64; 95% CI = 1.26-5.53) use.
CONCLUSIONS: Although older adults with severe/extreme knee and/or hip OA pain are more likely to take analgesics than those with less severe pain, a sizable proportion takes less than therapeutic doses and thus may be undertreated. Further research is needed to examine barriers to optimal analgesic use. Wiley Periodicals, Inc.

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Year:  2011        PMID: 21992521      PMCID: PMC3221937          DOI: 10.1111/j.1526-4637.2011.01249.x

Source DB:  PubMed          Journal:  Pain Med        ISSN: 1526-2375            Impact factor:   3.750


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