Diagnoses indicating pain and analgesic drug prescription in patients with dementia: a comparison to age- and sex-matched controls

BMC Geriatrics

Hanna Kaduszkiewicz¹  Gerd Glaeske³  Birgitt Wiese²  Hendrik van den Bussche¹  Falk Hoffmann³ 

[1] Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;Institute of Biometrics, Hannover Medical School, Hannover, Germany;Centre for Social Policy Research, Division Health Economics, Health Policy and Outcomes Research, University of Bremen, Postfach 33 04 40, D-28334 Bremen, Germany

关键词: Analgesics;    Pain;    Health services research;    Comorbidity;    Dementia;   

Others  :  855392
DOI  :  10.1186/1471-2318-14-20

 received in 2013-06-06, accepted in 2014-02-10,  发布年份 2014

【 摘 要 】

Background

The evidence of undertreatment of pain in patients with dementia is inconsistent. This may largely be due to methodological differences and shortcomings of studies. In a large cohort of patients with incident dementia and age- and sex-matched controls we examined (1) how often they receive diagnoses indicating pain, (2) how often they receive analgesics and (3) in which agents and formulations.

Methods

Using health insurance claims data we identified 1,848 patients with a first diagnosis of dementia aged ≥ 65 years and 7,385 age- and sex-matched controls. We analysed differences in diagnoses indicating pain and analgesic drugs prescribed between these two groups within the incidence year. We further fitted logistic regression models and stepwise adjusted for several covariates to study the relation between dementia and analgesics.

Results

On average, patients were 78.7 years old (48% female). The proportions receiving at least one diagnosis indicating pain were similar between the dementia and control group (74.4% vs. 72.5%; p = 0.11). The proportion who received analgesics was higher in patients with dementia in the crude analysis (47.5% vs. 44.7%; OR: 1.12; 95% CI: 1.01-1.24), but was significantly lower when adjusted for socio-demographic variables, care dependency, comorbidities and diagnoses indicating pain (OR: 0.78; 95% CI: 0.68-0.88). Analgesics in liquid form such as metamizole and tramadol were more often used in dementia.

Conclusions

Our findings show a comparable documentation of diagnoses indicating pain in persons with incident dementia compared to those without. However, there still seems to be an undertreatment of pain in patients with dementia. Irrespective of dementia, analgesics seem to be more often prescribed to sicker patients and to control pain in the context of mobility.

【 授权许可】

   
2014 Hoffmann et al.; licensee BioMed Central Ltd.

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