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

• Published in: PloS one Vol. 14; no. 9; p. e0222836
• Main Authors: Ingrasciotta, Ylenia, Sultana, Janet, Giorgianni, Francesco, Menditto, Enrica, Scuteri, Angelo, Tari, Michele, Tari, Daniele Ugo, Basile, Giorgio, Trifiro', Gianluca
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 19.09.2019; Public Library of Science (PLoS)
• Subjects: Aged; Aged, 80 and over; Analgesics; Analgesics - classification; Analgesics - therapeutic use; Analgesics, Opioid - classification; Analgesics, Opioid - therapeutic use; Anti-inflammatory agents; Anti-Inflammatory Agents, Non-Steroidal - classification; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Biology and Life Sciences; Cancer; Catchment areas; Chronic kidney failure; Chronic pain; Congestive heart failure; Coronary artery disease; Data bases; Demographics; Drug abuse; Drug therapy; Drug Utilization - statistics & numerical data; Drugs; Elderly; Female; General practitioners; General Practitioners - statistics & numerical data; Geriatrics; Health aspects; Heart failure; Heart Failure - drug therapy; Humans; Indomethacin; Inflammation; Italy; Kidney diseases; Male; Medicine and Health Sciences; Narcotics; Nonsteroidal anti-inflammatory drugs; Older people; Opioids; Pain; People and Places; Population; Population studies; Population Surveillance - methods; Population-based studies; Practice Patterns, Physicians' - statistics & numerical data; Prescription drugs; Prescriptions - statistics & numerical data; Primary care; Renal Insufficiency, Chronic - drug therapy; Researchers; Steroidal anti-inflammatory agents; Italy; United Kingdom > UK
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0222836

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