Consumption of oral analgesics and dosage forms in elderly patients: population based study

Objective

The objective of the study was to describe the consumption of oral analgesics (OA) in people aged ≥65 years, and distinguish between easy-to-swallow (ETS) formulations and solid forms.

Methods

Real data study with a cross sectional design. Electronic anonymous medical records of one year of primary care activity (July 2007–June 2008) were retrospectively reviewed. Inclusion criteria: patients aged ≥65 years receiving OA. Subgroups: institutionalized/non institutionalized. It was considered the oral analgesics use as a principal variable. Study variables: socio-demographic, pharmaceutical formulations (solid and ETS), co morbidities, type of analgesics, geriatric scales (Minimental, Barthel), and poly-medication. Multiple logistic regression analysis models were applied. Program SPSSWIN, statistical signification P<.05.

Results

Overall 78% patients regularly consumed OA. A total of 11 344 patients were studied; mean age 75.1 (7) years; female 61.5%. Two percent of patients were institutionalized and were older (OR=1.2), predominantly female (OR=1.3), had more co morbidity (OR=3.5; P<.001) and lower geriatric scale scores. OA were 13.8% of total drug consumption (95% CI, 13.2- 14.4); NSAIDs 69.5% and opioids 17.6%. Poly-medication 90.6% (96% institutionalized vs 90.5% non institutionalized; P=.019). Thirty-one point one percent of patients used ETS whose use was associated with stroke (OR=2.7), neuropathy (OR=2.4; P<.001), and urinary incontinence. Institutionalized patients consumption of paracetamol, tramadol, and aceclofenac was higher (54.3%, 19%, and 7.6%, respectively).

Conclusions

The use of OA was high, particularly in institutionalized patients. NSAIDs use was higher than expected compared to opioids that were lower than expected. The use of ETS analgesics was lower than expected given the reduced swallowing capacity of elderly patients.