Use of potentially inappropriate pain-related medications in older adults with painful neuropathic disorders

doi:10.1016/j.amjopharm.2004.09.005

The American Journal of Geriatric Pharmacotherapy

Volume 2, Issue 3, September 2004, Pages 163-170

https://doi.org/10.1016/j.amjopharm.2004.09.005 Get rights and content

Abstract

Background:

Although older adults with painful neuropathic disorders (PNDs) would appear to be at elevated risk for receiving potentially inappropriate pain-related medications, the extent of such drug use in this population is unknown.

Objective:

The goal of this study was to assess the use of potentially inappropriate pain-related medications among patients with PNDs aged ≥65 years.

Methods:

Using a large, integrated US health insurance database, we identified all persons aged ≥65 years with ≥2 medical encounters involving diagnoses of PNDs during calendar year 2000. Patients with <30 days of continuous eligibility for health benefits during the study year were excluded from the sample. Use of potentially inappropriate pain-related medications (as defined by the 1997 Beers criteria) was then examined based on information contained in paid pharmacy claims for all remaining patients.

Results:

We identified 22,668 patients with PNDs aged ≥65 years (mean [SD] age, 73.9 [6.0] years; 58.6% female). Almost one half (11,233 [49.6%]) of patients received ≥1 potentially inappropriate pain-related medication, including propoxyphene (26.7%) and amitriptyline (10.2%). Women were more likely than men to receive these medications (54.2% vs 43.0%, respectively; P < 0.01), and use increased with age (47.6%, 51.8%, and 52.8% in those aged 65–74 years, 75–84 years, and ≥85 years, respectively; overall comparison, P < 0.01). Among patients with only 1 PND, the use of potentially inappropriate medications was highest among those with postherpetic neuralgia (70.1%).

Conclusions:

Use of potentially inappropriate pain-related medications among older adults with PNDs is common. Further research is needed to ascertain whether the benefits of these agents outweigh their risks in this population.

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View full text

Use of potentially inappropriate pain-related medications in older adults with painful neuropathic disorders

Abstract

Background:

Objective:

Methods:

Results:

Conclusions:

Pain

J Am Pharm Assoc (Wash)

NINDS Peripheral Neuropathy Information Page

Psychological aspects of neuropathic pain

Clin J Pain

Anticonvulsants (antineuropathics) for neuropathic pain syndromes

Clin J Pain

Neuropathic pain

Epidemiology, physical examination, and neurodiagnostics

Spine

Neuralgias

Medline Plus Medical Encyclopedia

Postherpetic neuralgia pathogenesis, treatment, and prevention

N Engl J Med

Explicit criteria for determining potentially inappropriate medication use by the elderly. An update

Arch Intern Med.

Auditing prescription practice using explicit criteria and computerized drug benefit claims data

J Eval Clin Pract

Potentially inappropriate medication use in the community-dwelling elderly: Findings from the 1996 Medical Expenditure Panel Survey

JAMA

Suboptimal medication use in the elderly. The tip of the iceberg

JAMA

Inappropriate drug prescribing for the community-dwelling elderly

JAMA

Inappropriate drug prescriptions for elderly residents of board and care facilities

Am J Public Health

Inappropriate prescribing for the elderly: Beers criteria-based review

Ann Pharmacother

Administration of inappropriate medications to elderly emergency department patients: Results of a national survey

Acad Emerg Med

Pain: Pathophysiology and management

Treatment of post-herpetic neuralgia: Antidepressants

Ann Neural

Amitriptyline and fluphenazine in the treatment of postherpetic neuralgia

Clin J Pain