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New focus on pain medications in aged care


Use of analgesics and related medications is widespread in the residential aged care, according to a new study by pharmacists working in the sector.

The analysis of chronic pain management in Australian aged care found that prescribing of opiate analgesics was “widespread,” with products containing oxycodone used in 24 per cent of cases.

Analgesics and related medications are “associated with significant adverse effects, and older people may not tolerate doses that deliver satisfactory pain control,” it found.

The study by pharmacists at Ward Medication Management has been published in the Journal of Pharmacy Practice and Research.

Their analysis of 22, 319 medication reviews found that many residents were concurrently prescribed two or more analgesics. Adjuvant agents, which modify the effect of other agents, were prescribed in 3,073 cases.

“Use of medications for management of adverse effects associated with opioids was common,” they found.

Last month a review by researchers at the University of Sydney and UNSW found “a very high proportion of polypharmacy” in residential aged care.

The researchers found that negative clinical outcomes were rarely reported in five clinical areas they examined – with the exception of polypharmacy.

They noted that polypharmacy is not currently included in the government’s National Aged Care Quality Indicator Program.

While they found low incidence rates for pressure injuries, falls, unplanned weight loss and physical restraint, there was “a very high proportion of polypharmacy” with a prevalence rate of 42 per cent. Polypharmacy was defined as residents receiving nine or more medications.

Elsewhere, a leading pain expert has encouraged those living with chronic pain to explore solutions other than medications, as the Commonwealth’s changes to codeine access come into effect this month.

Dr Dr Philip Siddall , director of the HammondCare Greenwich Hospital Pain Clinic, said codeine-based medication is not generally an advisable treatment plan for chronic pain.

“Exercise and lifestyle changes, relaxation, meditation, distraction and pacing are among the tools available for meaningful pain relief,” he said.

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2 Responses to New focus on pain medications in aged care

  1. Leeanne Boswell February 15, 2018 at 5:17 am #

    I wonder if they did the same study in the community aged population whether they wouldn’t find the same results of poly pharmacy. Our residents are reviewed by MO and Pharmacist regularly and reports from RMMRs provided.

    Alternative non pharmaceutical methods of pain relief are utilised in aged Care including physiotherapiy pain management programs, heat packs, cold packs, psychology, TENs machines, with good short term results however there remains chronic pain that must be managed.

    Perhaps the researchers need to not only research data, but give and eat to the residents in aged Care and see how they find their pain and the effectiveness of pain management protocols in place. The situation is more complex than counting the number of medications used and the types of pain relief used.

  2. Urmila Sriskanda February 17, 2018 at 10:20 pm #

    Analgesics patches are effective in the elderly and provide long acting pain relief, however patches falling off can be a problem for nursing staff.

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