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. 2018 Feb;66(2):376-382.
doi: 10.1111/jgs.15238. Epub 2017 Dec 23.

Temporal Trends in Analgesic Use in Long-Term Care Facilities: A Systematic Review of International Prescribing

Francesca L La Frenais  1   2 , Rachel Bedder  1   3 , Victoria Vickerstaff  2 , Patrick Stone  2 , Elizabeth L Sampson  2   4
Affiliations

Temporal Trends in Analgesic Use in Long-Term Care Facilities: A Systematic Review of International Prescribing

Francesca L La Frenais et al. J Am Geriatr Soc. 2018 Feb.

Abstract

Objectives: To explore global changes in the prescription of analgesic drugs over time in the international long-term care (LTC) population.

Design: Systematic review.

Setting: We included original research articles in English, published and unpublished, that included number of participants, country and year(s) of data collection, and prescription of analgesics (analgesics not otherwise specified, opioids, acetaminophen; scheduled only, or scheduled plus as needed (PRN)).

Participants: LTC residents.

Measurements: We searched PubMed, EMBASE, CINAHL, International Pharmaceutical Abstracts, PsycINFO, Cochrane, Web of Science, Google Scholar, using keywords for LTC facilities and analgesic medication; hand-searched references of eligible papers; correspondence. Studies were quality rated using an adapted Newcastle-Ottawa scale. Pearson correlation coefficients were generated between percentage of residents prescribed an analgesic and year of data collection. If available, we investigated changes in acetaminophen and opioid prescriptions.

Results: Forty studies met inclusion criteria. A moderate correlation (0.59) suggested that scheduled prescription rates for analgesics have increased over time. Similar findings were reflected in scheduled prescriptions for acetaminophen and opioids. No increase was seen when analyzing scheduled plus PRN analgesics. Use of opioids (scheduled plus PRN) appears to have increased over time.

Conclusion: Worldwide, use of opioids and acetaminophen has increased in LTC residents. Research is needed to explore whether this reflects appropriate pain management for LTC residents and if PRN medication is used effectively.

Keywords: analgesics; dementia; nursing home; pain.

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Figures

Figure 1
Figure 1
Flow diagram of study selection.
Figure 2
Figure 2
Percentage of residents prescribed scheduled analgesic medication over time.
See this image and copyright information in PMC

References

    1. OECD Health Policy Studies, OECD Publishing . A Good Life in Old Age? Monitoring and Improving Quality in Long‐Term Care. Paris: OECD Health Policy Studies, OECD Publishing, 2013.
    1. Knapp M, Comas‐Herrera A, Somani A et al. Dementia: International Comparisons. London, UK: Personal Social Services Research Unit, London School of Economics and Political Science and the Institute of Psychiatry, King's College London, 2007.
    1. Changes in the Older Resident Care Home Population . Between 2001 and 2011. London: Office for National, Statistics, 2014.
    1. Lukas A, Mayer B, Fialová D et al. Treatment of pain in European nursing homes: Results from the Services and Health for Elderly in Long TERm Care (SHELTER) study. J Am Med Dir Assoc 2013;14:821–831. - PubMed
    1. Hughes L, Hanslip J, Witham M. Centrally active prescribing for nursing home residents‐how are we doing? Eur Geriatr Med 2012;3:304–307.

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