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Prevalence, characteristics and treatment of chronic pain in elderly patients hospitalized in internal medicine wards

  • Nicole Corsi
    Correspondence
    Corresponding author at: Pain and Palliative Care Research Unit, Oncology Department, IRCCS Mario Negri Institute for Pharmacological Research, Via G. La Masa 19, Milan, Italy.
    Affiliations
    Pain and Palliative Care Research Unit, Oncology Department, IRCCS-Mario Negri Institute for Pharmacological Research, Milan, Italy
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  • Anna Roberto
    Affiliations
    Pain and Palliative Care Research Unit, Oncology Department, IRCCS-Mario Negri Institute for Pharmacological Research, Milan, Italy
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  • Laura Cortesi
    Affiliations
    Quality Assessment of Geriatric Therapies and Services Laboratory, Neuroscience Department, IRCCS-Mario Negri Institute for Pharmacological Research, Milan, Italy
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  • Alessandro Nobili
    Affiliations
    Quality Assessment of Geriatric Therapies and Services Laboratory, Neuroscience Department, IRCCS-Mario Negri Institute for Pharmacological Research, Milan, Italy
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  • Pier Mannuccio Mannucci
    Affiliations
    Scientific Direction, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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  • Oscar Corli
    Affiliations
    Pain and Palliative Care Research Unit, Oncology Department, IRCCS-Mario Negri Institute for Pharmacological Research, Milan, Italy
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  • REPOSI Investigators
    Author Footnotes
    1 Please, refer to the Supplementary Data, Appendix.
  • Author Footnotes
    1 Please, refer to the Supplementary Data, Appendix.

      Highlights

      • More than a half of chronic pain patients are not treated at admission.
      • Almost a half of chronic pain patients are still not treated at discharge.
      • Treated chronic patients do not decrease significantly their pain intensity.
      • It is a needed a greater attention to the management of chronic pain in elderly.

      Abstract

      Background

      Chronic pain is a frequent characteristic of elderly people and represents an actual and still poorly debated topic.

      Objective

      We investigated pain prevalence and intensity, and its pharmacological therapy in elderly patients hospitalized in 101 internal medicine wards.

      Methods

      Taking advantage of the “REgistro POliterapie Società Italiana Medicina Interna” (REPOSI), we collected 2535 patients of whom almost a quarter was older than 85 years old. Among them, 582 patients were affected by pain (either chronic or acute) and 296 were diagnosed with chronic pain.

      Results

      Patients with pain showed worse cognitive status, higher depression and comorbidities, and a longer duration of hospital stay compared to those without pain (all p < .0366). Patients with chronic pain revealed lower level of independency in their daily life, worse cognitive status and higher level of depression compared to acute pain patients (all p < .0156). Moreover, most of them were not treated for pain at admission (73.4%) and half of them was not treated with any analgesic drug at discharge (50.5%). This difference affected also the reported levels of pain intensity. Patients who received analgesics at both admission and discharge remained stable (p = .172). Conversely, those not treated at admission who received an analgesic treatment during the hospital stay decreased their perceived pain (p < .0001).

      Conclusions

      Our results show the need to focus more attention on the pharmacological treatment of chronic pain, especially in hospitalized elderly patients, in order to support them and facilitate their daily life after hospital discharge.

      Keywords

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