Treatment Guidelines for the Pharmacological Management of Pain in Older Persons

Pain Medicine

Volumn 13, Issue SUPPL. 2, 2012, Pages

  Fine, Perry G ^a  

^a UNIVERSITY OF UTAH SCHOOL OF MEDICINE   (United States)

Author keywords

Guidelines; Older patients; Pain; Pharmacotherapy

Indexed keywords

ACETYLSALICYLIC ACID; ANTIHYPERTENSIVE AGENT; BENZODIAZEPINE; CAPSAICIN; CORTICOSTEROID; DICLOFENAC; DIURETIC AGENT; DULOXETINE; GABAPENTIN; LIDOCAINE; MUSCLE RELAXANT AGENT; NONSTEROID ANTIINFLAMMATORY AGENT; OPIATE; PARACETAMOL; ROFECOXIB; SALICYLIC ACID DERIVATIVE; VALDECOXIB; WARFARIN;

ADJUVANT THERAPY; AGED; AGING; ANALGESIA; APPLICATION SITE REACTION; BODY MOVEMENT; BONE PAIN; BRIEF PAIN INVENTORY; CANCER PAIN; CARDIOVASCULAR DISEASE; CLINICAL PRACTICE; CONGESTIVE HEART FAILURE; CONSTIPATION; CORONARY ARTERY DISEASE; DAILY LIFE ACTIVITY; DELIRIUM; DIABETIC NEUROPATHY; DIZZINESS; DRUG CLEARANCE; DRUG DISTRIBUTION; DRUG DOSE REDUCTION; FACIAL EXPRESSION; FACIAL PAIN SCALE; FALLING; FIBROMYALGIA; FRACTURE; GASTROINTESTINAL ABSORPTION; GASTROINTESTINAL HEMORRHAGE; GASTROINTESTINAL TOXICITY; GASTROINTESTINAL TRACT FUNCTION; GERIATRIC PAIN MEASURE; GERIATRIC PATIENT; GIANT CELL ARTERITIS; GOUT; HEART FAILURE; HERPES ZOSTER; HUMAN; INJURY; INTERPERSONAL COMMUNICATION; KIDNEY FUNCTION; LIVER FUNCTION; LOW BACK PAIN; LOW DRUG DOSE; MENTAL HEALTH; MYALGIA; MYOFASCIAL PAIN; NAUSEA; NEPHROTOXICITY; NEUROPATHIC PAIN; NEUROPATHY; NUMERIC RATING SCALE; OSTEOARTHRITIS; OSTEOPOROSIS; PAIN; PEPTIC ULCER BLEEDING; PERIPHERAL NEUROPATHY; POSTHERPETIC NEURALGIA; PRACTICE GUIDELINE; RADICULAR PAIN; RATING SCALE; RESPIRATION DEPRESSION; REVIEW; RHEUMATOID ARTHRITIS; RISK ASSESSMENT; SEIZURE; SIDE EFFECT; SOMNOLENCE; TENDINITIS; TREATMENT DURATION; TRIGEMINAL NERVE; VERBAL DESCRIPTOR SCALE; VERBALIZATION; VOCALIZATION; VOMITING;

EID: 84859809603     PISSN: 15262375     EISSN: 15264637     Source Type: Journal    
DOI: 10.1111/j.1526-4637.2011.01307.x     Document Type: Article

References (30)

1. American Geriatrics Society Panel on the Pharmacological Management of Persistent Pain in Older Persons. Pharmacological management of persistent pain in older persons. J Am Geriatr Soc 2009;57:1331-46.
2. Bjoro K, Herr K. Assessment of pain in the nonverbal or cognitively impaired older adult. Clin Geriatr Med 2008;24:237-62.
3. Vincent GK, Velkoff VA. The Next Four Decades: The Older Population in the United States: 2010 to 2050, Current Population Reports. P25-1138, U.S. Census Bureau, Washington, DC: May 2010.
4. Cavalieri TA. Pain management in the elderly. J Am Osteopath Assoc 2002;102:481-5.
5. Kemp CA, Ersek M, Turner JA. A descriptive study of older adults with persistent pain: Use and perceived effectiveness of pain management strategies (ISRCTN11899548). BMC Geriatr 2005;5:12.
6. Schneider H, Cristian A. Role of rehabilitation medicine in the management of pain in older adults. Clin Geriatr Med 2008;24:313-34. vii.
7. McCleane G. Pharmacological pain management in the elderly patient. Clin Interv Aging 2007;2(4):637-43.
8. Agin CW, Glass PS. Tolerance and aging: Optimizing analgesia in pain management. Anesth Analg 2005;100:1731-2.
9. Glajchen M. Chronic pain: Treatment barriers and strategies for clinical practice. J Am Board Fam Pract 2001;14:211-8.
10. Nygaard HA, Jarland M. Are nursing home patients with dementia diagnosis at increased risk for inadequate pain treatment? Int J Geriatr Psychiatry 2005;20:730-7.
11. Reynolds KS, Hanson LC, DeVellis RF, etal. Disparities in pain management between cognitively intact and cognitively impaired nursing home residents. J Pain Symptom Manage 2008;35:388-96.
12. Morley-Forster PK, Clark AJ, Speechley M, Moulin DE. Attitudes toward opioid use for chronic pain: A Canadian physician survey. Pain Res Manag 2003;8:189-94.
13. Pergolizzi J, Böger RH, Budd K, etal. Opioids and the management of chronic severe pain in the elderly: Consensus statement of an International Expert Panel with focus on the six clinically most often used World Health Organization Step III opioids (buprenorphine, fentanyl, hydromorphone, methadone, morphine, oxycodone). Pain Pract 2008;8(4):287-313.
14. Fine PG, Herr KA. Pharmacologic management of persistent pain in older persons. Clin Geriatr 2009;17(4):25-32.
15. Bonnewyn A, Katona C, Bruffaerts R, etal. Pain and depression in older people: Comorbidity and patterns of help seeking. J Affect Disord 2009;117(3):193-6.
16. Landi F, Russo A, Liperoti R, etal. Daily pain and functional decline among old-old adults living in the community: Results from the ilSIRENTE Study. J Pain Symptom Manage 2009;38(3):350-7.
17. Snow AL, Chandler JF, Kunik ME, etal. Self-reported pain in persons with dementia predicts subsequent decreased psychosocial functioning. Am J Geriatr Psychiatry 2009;17(10):873-80.
18. US Food and Drug Aministration Advisory Committee Calendar. June 29-30, 2009: Joint Meeting of the Drug Safety and Risk Management Advisory Committee with the Anesthetic and Life Support Drugs Advisory Committee and the Nonprescription Drugs Advisory Committee: Meeting Announcement; 2011. Available at: (accessed November 2011).
19. Franceschi M, Scarcelli C, Niro V, etal. Prevalence, clinical features and avoidability of adverse drug reactions as cause of admission to a geriatric unit: A prospective study of 1, 756 patients. Drug Saf 2008;31:545-56.
20. Richy F, Bruyere O, Ethgen O, etal. Time dependent risk of gastrointestinal complications induced by non-steroidal anti-inflammatory drug use: A consensus statement using a meta-analytic approach. Ann Rheum Dis 2004;63:759-66.
21. Heerdink ER, Leufkens HG, Herings RM, etal. NSAIDs associated with increased risk of congestive heart failure in elderly patients taking diuretics. Arch Intern Med 1998;158:1108-12.
22. Mason L, Moore RA, Edwards JE, etal. Topical NSAIDs for chronic musculoskeletal pain: Systematic review and meta-analysis. BMC Musculoskelet Disord 2004;5:28.
23. Chou R, Fanciullo GJ, Fine PG, etal. American Pain Society-American Academy of Pain Medicine Opioids Guidelines Panel. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain 2009;10:113-30.
24. Hadjistavropoulos T, Herr K, Turk DC, etal. An interdisciplinary expert consensus statement of assessment of pain in older persons. Clin J Pain 2007;23(1 suppl):S1-43.
25. Morone NE, Greco CM. Mind-body interventions for chronic pain in older adults: A structured review. Pain Med 2007;8:359-75.
26. Christo PF, Li S, Gibson S, Fine PG. Effective treatments for pain in the older patient. Curr Pain Headache Rep 2011;15(1):22-34.
27. Bruckenthal P. Assessment of pain in the elderly adult. Clin Geriatr Med 2008;24:213-36, v-vi.
28. Herr K, Bursch H, Ersek M, etal. Use of pain-behavioral assessment tools in the nursing home: Expert consensus recommendations for practice. J Gerontol Nurs 2010;36:18-31.
29. Blozik E, Stuck AE, Niemann S, etal. Geriatric Pain Measure short form: Development and initial evaluation. J Am Geriatr Soc 2007;55(12):2045-50.
30. Geriatric Pain web site; 2011. Available at: (accessed November 2011).