Management of Painful Conditions in the Elderly

Persistent pain conditions in the elderly are most often due to degenerative disorders of the spine, osteoarthritis of the joints, malignant cancer, and vascular disorders. The consequences of persistent pain include depression, anxiety, de-creased socialization, sleep disturbance, impaired ambulation, and increased healthcare utilization. Proper pain assessment is the key to selecting appropriate treatment. Barriers to pain assessment are associated with the patient's perception of pain and the caregiver's attitude towards providing effective treatment. All elderly patients have age-related physiologic changes that affect absorption, distribution, metabolism, and clearance of medications used for pharmacologic treatment. Medications used in pain management include opioids, nonsteroidal anti-inflammatory drugs, gabapentin, nortriptylline, desipramine, and lidocaine 5%patch. Pharmacists have an important role in the monitoring of medications in elderly. As the utilization of prescription medication continues to increase in the elderly, pharmacists are becoming the frontline of healthcare care for this population.