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Analgesic drug use in elderly persons: A population-based study in Southern Italy


Autoři: Ylenia Ingrasciotta aff001;  Janet Sultana aff001;  Francesco Giorgianni aff002;  Enrica Menditto aff003;  Angelo Scuteri aff004;  Michele Tari aff005;  Daniele Ugo Tari aff005;  Giorgio Basile aff001;  Gianluca Trifiro’ aff001
Působiště autorů: Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy aff001;  Unit of Clinical Pharmacology A.O.U. ‘G. Martino’ Hospital’, Messina, Italy aff002;  CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, Naples, Italy aff003;  HSR Pisana IRCCS, Rome, Italy aff004;  Local Health Unit of Caserta, Caserta, Italy aff005;  Department of Medical Informatics, Erasmus Medical Center, Rotterdam, the Netherlands aff006
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0222836

Souhrn

Introduction

Analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs), weak and strong opioids are commonly used among elderly persons. The aim of this study was to describe the demographic and clinical characteristics of elderly analgesic users and to measure the frequency of analgesic use, including the frequency of potentially inappropriate analgesic use.

Methods

The Arianna database was used to carry out this study. This database contains prescription data with associated indication of use for 1,076,486 inhabitants registered with their general practitioners (GPs) in the Caserta Local Health Unit (Caserta district, Campania region in Italy). A cohort of persons aged ≥65 years old with >1 year of database history having at least one analgesic drug (NSAIDs, strong or weak opioids) between 2010 and 2014 were identified. The date of the first analgesic prescription in the study period was considered the index date (ID).

Results

From a source population of 1,076,486 persons, 116,486 elderly persons were identified. Of these, 94,820 elderly persons received at least one analgesic drug: 36.6% were incident NSAID users (N = 36,629), while 13.2% were incident weak opioid users (N = 12,485) and 8.1% were incident strong opioid users (N = 7,658). In terms of inappropriate analgesic use, 9.2% (N = 10,763) of all elderly users were prescribed ketorolac/indomethacin inappropriately, since these drugs should not be prescribed to elderly persons. Furthermore, at least half all elderly persons with chronic kidney disease or congestive heart failure were prescribed NSAIDs, while these drugs should be avoided.

Conclusion

Analgesics are commonly used inappropriately among elderly persons, suggesting that prescribing practice in the catchment area may yet be improved.

Klíčová slova:

Medicine and health sciences – Pharmacology – Drugs – Analgesics – Opioids – NSAIDs – Pain management – Geriatrics – Pharmaceutics – Drug therapy – Antiplatelet therapy – Neurology – Cognitive neurology – Cognitive impairment – People and places – Population groupings – Age groups – Elderly – Ethnicities – European people – Italian people – Biology and life sciences – Neuroscience – Cognitive science – Cognitive neuroscience


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