Max
05-11-2002, 09:10 AM
Geriatrics Group Issues Guidelines for Treating Pain
Fri May 10, 5:40 PM ET
By Allyson Vaughan
WASHINGTON (Reuters Health) - David Cohen's spine hurt so much a few years ago that he needed to use a wheelchair. After surgery in 1997 and drug therapy, including the use of an anti-inflammatory drug, he says that his pain is now under control.
"It has given me some relief from the pain," said Cohen, 75. Although he no longer plays tennis, the Lutherville, Maryland-based senior walks with the help of a cane and runs an insurance agency.
The anecdote is just one success story showing how modern treatments can help seniors manage pain. As many as 4 out of 10 older adults experience chronic pain, Dr. Jerry Johnson, president of the American Geriatrics Society, told reporters at a press conference Thursday to release the Society's new guidelines on treating pain in seniors.
The guidelines, which were last published in 1998, needed to be updated to include new drugs and therapies, said Dr. Bruce Ferrell, an associate professor of medicine at the University of California, Los Angeles, who is trained in geriatric medicine.
According to the American Geriatrics Society, the first drug to be considered in treating muscle and skeletal pain is acetaminophen, the active ingredient in Tylenol and other drugs.
For those who require a long-term analgesic, a new class of anti-inflammatory drugs known as COX-2 inhibitors, which include drugs such as Celebrex and Vioxx, may be preferable to other anti-inflammatories, such as aspirin or ibuprofen.
Although such drugs are much more expensive, some types have been shown to reduce the risk of gastrointestinal problems compared with older drugs. However, some of the newer drugs have also been shown to carry a higher risk of cardiovascular problems than older medication.
Opioid-based drugs are effective and have "a low potential for addiction" when it comes to treating older persons with persistent pain, according to the guidelines. But there are many challenges in managing pain for the elderly, particularly because of concerns that the painkillers will end up in the wrong hands. A handful of states, including New York and California, require triple prescriptions for the potent drugs, which include the painkiller Oxycontin.
Such opiate medications require special prescription pads, which doctors don't always have available. "That does nothing to curb illicit drug use. It just restricts access to those who need the medication," according to Dr. F. Michael Gloth of Johns Hopkins University School of Medicine in Baltimore, Maryland.
Some patients also require multiple references, depending on their health plan, to see pain specialists. It needlessly delays access to medication, Gloth told Reuters Health.
There are other concerns about the side effects of drugs, possible addiction, and the expense of drugs that can prevent the elderly from getting the care they need, the doctors pointed out. Meanwhile, there is litigation pending in California over failure to provide adequate pain management at a nursing home.
"Consumers must be their own best advocate when it comes to their healthcare," said Sara Cooper, executive vice president of the National Consumers League. Patients should keep track of pain, discuss appropriate medication and exercise with healthcare providers, and join support groups for pain, she said.
The guidelines were funded by unrestricted educational grants from Janssen Pharmaceutica, McNeil Consumer & Specialty Pharmaceuticals (the maker of Tylenol), Ortho-McNeil Pharmaceutical Inc., Pharmacia Corporation (the maker of Celebrex) and Purdue Pharma LP (the maker of OxyContin).
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Fri May 10, 5:40 PM ET
By Allyson Vaughan
WASHINGTON (Reuters Health) - David Cohen's spine hurt so much a few years ago that he needed to use a wheelchair. After surgery in 1997 and drug therapy, including the use of an anti-inflammatory drug, he says that his pain is now under control.
"It has given me some relief from the pain," said Cohen, 75. Although he no longer plays tennis, the Lutherville, Maryland-based senior walks with the help of a cane and runs an insurance agency.
The anecdote is just one success story showing how modern treatments can help seniors manage pain. As many as 4 out of 10 older adults experience chronic pain, Dr. Jerry Johnson, president of the American Geriatrics Society, told reporters at a press conference Thursday to release the Society's new guidelines on treating pain in seniors.
The guidelines, which were last published in 1998, needed to be updated to include new drugs and therapies, said Dr. Bruce Ferrell, an associate professor of medicine at the University of California, Los Angeles, who is trained in geriatric medicine.
According to the American Geriatrics Society, the first drug to be considered in treating muscle and skeletal pain is acetaminophen, the active ingredient in Tylenol and other drugs.
For those who require a long-term analgesic, a new class of anti-inflammatory drugs known as COX-2 inhibitors, which include drugs such as Celebrex and Vioxx, may be preferable to other anti-inflammatories, such as aspirin or ibuprofen.
Although such drugs are much more expensive, some types have been shown to reduce the risk of gastrointestinal problems compared with older drugs. However, some of the newer drugs have also been shown to carry a higher risk of cardiovascular problems than older medication.
Opioid-based drugs are effective and have "a low potential for addiction" when it comes to treating older persons with persistent pain, according to the guidelines. But there are many challenges in managing pain for the elderly, particularly because of concerns that the painkillers will end up in the wrong hands. A handful of states, including New York and California, require triple prescriptions for the potent drugs, which include the painkiller Oxycontin.
Such opiate medications require special prescription pads, which doctors don't always have available. "That does nothing to curb illicit drug use. It just restricts access to those who need the medication," according to Dr. F. Michael Gloth of Johns Hopkins University School of Medicine in Baltimore, Maryland.
Some patients also require multiple references, depending on their health plan, to see pain specialists. It needlessly delays access to medication, Gloth told Reuters Health.
There are other concerns about the side effects of drugs, possible addiction, and the expense of drugs that can prevent the elderly from getting the care they need, the doctors pointed out. Meanwhile, there is litigation pending in California over failure to provide adequate pain management at a nursing home.
"Consumers must be their own best advocate when it comes to their healthcare," said Sara Cooper, executive vice president of the National Consumers League. Patients should keep track of pain, discuss appropriate medication and exercise with healthcare providers, and join support groups for pain, she said.
The guidelines were funded by unrestricted educational grants from Janssen Pharmaceutica, McNeil Consumer & Specialty Pharmaceuticals (the maker of Tylenol), Ortho-McNeil Pharmaceutical Inc., Pharmacia Corporation (the maker of Celebrex) and Purdue Pharma LP (the maker of OxyContin).
More from > Health
Prev. Story: Interest Groups Battle Over Medicare Drug Plan Ads
Fri May 10, 5:44 PM ET - (Reuters)
Next Story: Court Orders Georgia Insurer to Disclose Doc Fees
Fri May 10, 5:39 PM ET - (Reuters)