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

La Frenais, FL; Bedder, R; Vickerstaff, V; Stone, P; Sampson, EL; (2018) Temporal Trends in Analgesic Use in Long-Term Care Facilities: A Systematic Review of International Prescribing. Journal of the American Geriatrics Society , 66 (2) pp. 376-382. 10.1111/jgs.15238. Green open access

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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 SETTING: We included original research articles in English, published and unpublished, that included number of participants, country and year(s) of data collection, and prescription of analgesics (analgesics not otherwise specified, opioids,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.

Type: Article
Title: Temporal Trends in Analgesic Use in Long-Term Care Facilities: A Systematic Review of International Prescribing.
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/jgs.15238
Publisher version: http://dx.doi.org/10.1111/jgs.15238
Language: English
Additional information: © 2017 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Keywords: Analgesics, dementia, nursing home, pain
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10041358
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