Pharmacologic Management of Osteoarthritis-Related Pain in Older Adults

A Review Shows that Many Drug Therapies Provide Small-to-Modest Pain Relief

Overview:

Because pain is a common and debilitating symptom of osteoarthritis in older adults, the authors reviewed data on the efficacy and safety of commonly used oral, topical, and intraarticular drug therapies in this population. A search of several databases found that most studies have focused on knee osteoarthritis and reported only short-term outcomes. Also, treatment efficacy was found to vary by drug class; the smallest effect was observed with acetaminophen and the largest with opioids and viscosupplements. Acetaminophen and topical agents had the best safety profiles, whereas oral nonsteroidal antiinflammatory drugs and opioids had the worst. Little data were available on patients ages 75 years old and older and on patients from diverse racial and ethnic groups. Most drug therapies gave mild-to-moderate pain relief; their long-term safety and efficacy and their effects in diverse populations (particularly older adults) remain undetermined.

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M. Carrington Reid is an associate attending physician at New York–Presbyterian Hospital and an associate professor of medicine at Weill Cornell Medical College (WCMC) in New York City. Rouzi Shengelia is a research assistant at WCMC. Samantha J. Parker is a former research assistant at WCMC and a current medical student at Tulane University Schoolof Medicine in New Orleans, LA. This research project was supported by an unrestricted educational grant from the National Institute on Aging: an Edward R. Roybal Center Grant (P30AG022845). Contact author: M. Carrington Reid, mcr2004@med.cornell.edu. The authors have disclosed no potential conflicts of interest, financial or otherwise.

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Correspondence to M. Carrington Reid MD, PhD.

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This article was produced by the American Journal of Nursing (AJN), which is publishing it in its March 2012 issue. For access to all the articles in this special AJN supplement on osteoarthritis, go to www.AJNonline.com.

Reprinted with permission from American Journal of Nursing, 112(3), S38-S43, 2012

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Reid, M.C., Shengelia, R. & Parker, S.J. Pharmacologic Management of Osteoarthritis-Related Pain in Older Adults. HSS Jrnl 8, 159–164 (2012). https://doi.org/10.1007/s11420-012-9273-0

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Keywords

  • Analgesia
  • older adults
  • osteoarthritis
  • pain