• Kaisu H Pitkala, Timo E Strandberg, and Reijo S Tilvis.
• Helsinki University Hospital, Department of Medicine, Geriatric Clinic, Helsinki, Finland. kaisu.pitkala@hus.fi
• J Am Geriatr Soc. 2002 Nov 1; 50 (11): 1861-5.

ObjectivesTo investigate use of prescribed analgesic drugs in relation to experience of joint or back pain in a home-dwelling older population, to study changes in the use of analgesic drugs over 10 years, and to investigate concomitant use of protective gastrointestinal drugs with prescribed analgesic drugs in 1999.DesignCross-sectional mailed surveys 10 years apart.SettingHelsinki, Finland.ParticipantsRandom samples of older birth cohorts born in 1904, 1909, and 1914 in 1989 (n = 644) (n=644)-->, and of three separate cohorts born in 1914, 1919, and 1924 in 1999 (n = 3,000).MeasurementsUse of various types of analgesic and protective gastrointestinal drugs, prescribed and over the counter. Experience of joint and back pain that interferes with daily functioning.ResultsThe response rate of home-dwelling older people was 83% in 1989 and 81% in 1999. Although the use of analgesic drugs as self-treatment increased from 28.5% to 41.4% during the 10 years, in 1999, only 35.5% to 38.2% of those suffering joint or back pain that impaired daily functioning had been prescribed an analgesic drug for regular use. Of those using prescribed medication, 57.5% were on nonsteroidal antiinflammatory drugs (NSAIDs), 20.9% acetaminophen, and 18.5% weak opiates. Only one-fifth of those individuals taking NSAIDs were on a concomitant gastroprotective drug.ConclusionsPain is markedly undertreated in community-dwelling older people, which may have serious implications for their well-being and functioning. Although we noted a tendency for safety in the use of prescribed analgesic drugs, a significant effort must sill be made to implement evidence-based practice. Self-treatment of pain has increased in 1 decade, which may reduce the overall safety of analgesic drug use among older people.

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