Minimising Harm and Managing Pain: Deprescribing Opioids in Older Adults.

Autor: Langford AV; Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Rm 401, Badham Building A16, Camperdown, 2006, Sydney, NSW, Australia. aili.langford@sydney.edu.au.; Faculty of Pharmacy and Pharmaceutical Sciences, Centre for Medicine Use and Safety, Monash University, Parkville, VIC, Australia. aili.langford@sydney.edu.au., Schneider CR; Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Rm 401, Badham Building A16, Camperdown, 2006, Sydney, NSW, Australia., Reeve E; Faculty of Pharmacy and Pharmaceutical Sciences, Centre for Medicine Use and Safety, Monash University, Parkville, VIC, Australia.; Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia., Gnjidic D; Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Rm 401, Badham Building A16, Camperdown, 2006, Sydney, NSW, Australia.
Jazyk: angličtina
Zdroj: Drugs & aging [Drugs Aging] 2024 Nov; Vol. 41 (11), pp. 863-871. Date of Electronic Publication: 2024 Oct 29.
DOI: 10.1007/s40266-024-01154-5
Abstrakt: Approximately one in three older adults (aged 65 years and over) experience pain, negatively impacting their quality of life. Opioid analgesics are commonly prescribed to manage pain; however, balancing the benefits and harms of these high-risk analgesics can be challenging for both healthcare professionals and patients. This is particularly true for older adults, as factors such as polypharmacy, age-related physiological changes and cognitive decline may impact upon opioid safety and efficacy. Deprescribing is the patient-centred process of reducing or discontinuing a medication that is no longer appropriate, or where the risks of continuation are deemed to outweigh the anticipated benefits. Opioid deprescribing has been proposed as a mechanism to reduce individual and societal opioid-related harm; however, to date, research has predominantly focused on the general adult population, rather than older adults. This current opinion aims to summarise the existing opioid deprescribing literature, discussing its applicability for older adults. Drawing on a non-systematic review of the literature, it identifies unique challenges and considerations for this population, highlights international initiatives to enhance opioid deprescribing in clinical practice and proposes future directions to advance the field.
Competing Interests: Declarations Funding Open Access funding enabled and organized by CAUL and its Member Institutions. Aili V. Langford and Emily Reeve are supported by National Health and Medical Research Council Investigator Grants (2025289, 1195460), Danijela Gnjidic is supported by a University of Sydney Equity Prize - Thompson Fellowship. Author contribution All authors contributed to the conceptualisation of this article. Aili V. Langford wrote the first draft which was refined with critical input from Carl R. Schneider, Emily Reeve and Danijela Gnjidic. Conflicts of interest/competing interests Aili V. Langford, Carl R. Schneider, Emily Reeve and Danijela Gnjidic have no conflicts of interest that are directly relevant to the content of this article. Ethics approval Not applicable. Consent to participate Not applicable. Consent for publication Not applicable. Availability of data and material Not applicable. Code availability Not applicable.
(© 2024. The Author(s).)
Databáze: MEDLINE
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