International guidelines on management of chronic non-cancer pain in older adults aged ≥ 65 years: a systematic review
Year: 2025
Type: article
Study design: Systematic Review
Abstract: Chronic non-cancer pain (CNCP) is a moderate or severe pain that is not caused by cancer and that persists for six months or more. It is a common condition with an increased prevalence in older adults and managed often in outpatient care requiring a combination of non-pharmacological and pharmacological treatment. The latter one poses many challenges due to specific characteristics of geriatric population such as age-related changes in pharmacodynamics and pharmacokinetics of drugs, relatively high prevalence of multimorbidity and polypharmacy. Other barriers to the management of chronic pain in this population include older patients’ wrong beliefs that pain is a normal part of ageing and susceptibility of older adults to adverse effects of analgesics and other drugs with analgesic properties. Due to under-representation of geriatric population in clinical trials, specialists with geriatric expertise involved in development of clinical guidelines on management of chronic pain in older adults do not have a sufficient amount of data to establish benefit-to-harm ratio when it comes to the pharmacological treatment. The purpose of this study is to systematically examine existing evidence on the pharmacological treatment of chronic non-cancer pain in older adults aged ≥ 65 years in outpatient care and assess the quality of the evidence. The research method is a systematic review without meta-analysis. As for eligibility criteria, the study included articles published till October 2024 from inception, written in English with a target population of patients aged ≥ 65 years in outpatient care setting suffering from a chronic non-cancer pain. The study design of the included studies were systematic reviews with and without meta-analysis, scoping reviews, umbrella reviews and original articles. As a result of the first screening process, no systematic review with or without meta-analysis, scoping review or umbrella review meeting the inclusion criteria was found. One original research article, a guideline by American Geriatrics Society, meeting the inclusion criteria was identified and accepted for further analysis. After the second screening, 17 reviews and commentaries were included to examine what kind of research evidence was included in the guidelines covering the treatment of CNCP in older adults aged ≥ 65 years during the last decade from January 2015 till the end of October of 2024. The results of this study indicate that research evidence base on pharmacological recommendations concerning CNCP treatment in older adults aged ≥ 65 years is still scarce with no significant changes having occurred during the last decade after the last update of the guideline by American Geriatrics Society was conducted in 2009.
Source: Työväentutkimus Vuosikirja
Author: Mataeva, Hedi
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7198665803