Guidance on opioids prescribing for the management of persistent non-cancer pain in older adults

作     者：Fabio Guerriero 

作者机构：Department of Internal Medicine and Thera-peuticsSection of GeriatricsUniversity of Pavia 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2017年第5卷第3期

页      面：73-81页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

主　　题：Chronic pain Opioids Pain management Elderly 

摘      要：Many older adults suffer from persistent pain but prevalence studies consistently showed high levels of untreated or under-treated pain in old population.Both persistent pain and pain under-treatment adversely affect independence and quality of life in geriatric patients.Pain management is challenging in this age-group because of the declining organ function,the presence of concurrent diseases and polypharmacy.For all the above reasons,persistent pain in the elderly should be considered a geriatric syndrome per se and effective approaches are warranted.Current guidelines and consensus statements recommend opioid therapy for older adults with moderateto-severe persistent pain or functional impairment and diminished quality of life due to pain.However clinicians and patients themselves have some concerns about opioids use.Age-related decline in organs functions and warnings about risk of addiction and drug misuse/abuse also in geriatric patients need particular attention for safe prescribing.On the basis of clinical evidence,these practical recommendations will help to improve the competence on opioid role in persistent pain management and the likelihood of a successful analgesic trial in older patients.