Pharmacological management of chronic non-cancer pain in frail older people

Abstract

Chronic non-cancer pain is a common problem among older people and has a significant impact on their quality of life. Medical comorbidities and polypharmacy are often additional challenges in managing these patients. Appropriate assessment of chronic non-cancer pain is important for the development of a patient-centred, goal-directed management plan. When assessing patients with cognitive impairment, modified communication strategies and validated pain assessment tools can be useful. The quantity and quality of the evidence supporting individual drugs in the management of chronic non-cancer pain varies and studies focused on frail older people are limited. Caution is generally advised when introducing drugs and escalating the doses. Drugs that are not effective should be stopped. A shared decision-making approach is advised for deprescribing analgesics used for chronic non-cancer pain.