Analgesic use in older adults with back pain: the BACE study

Pain Med. 2014 Oct;15(10):1704-14. doi: 10.1111/pme.12515. Epub 2014 Aug 4.

Abstract

Background: Older patients with back pain are more likely to visit their general practitioner (GP) and are more likely to be prescribed analgesics.

Objective: To assess analgesic use in older adults with back pain in general practice.

Methods: The BACE study in the Netherlands is a prospective cohort study. Patients (aged >55 years) with back complaints were recruited when consulting their GP or shortly thereafter. Measurements took place at baseline and at 3- and 6-month follow-up. For medication use, patients were asked if they had used any medication for their back pain in the previous 3 months and, if so, to specify the medication name, dosage used, frequency of usage, and whether the medication was prescribed or purchased over the counter.

Results: Of the 1,402 patients who were approached to enter the study, 675 were included. Of these patients, 484 (72%) reported medication use at baseline. Nonsteroidal anti-inflammatory drugs (NSAIDs) (57%) were more often used than paracetamol (49%). Paracetamol was mostly obtained over the counter (69%), and NSAIDs were mostly obtained by prescription (85%). At baseline, patients with severe pain (numerical rating scale score ≥7) used more paracetamol, opioids, and muscle relaxants. Patients with chronic pain (back pain >3 months) used more paracetamol, while patients with a shorter duration of pain used more NSAIDs. During follow-up there was an overall decline in medication use; however, at 3- and 6-month follow-up, 36% and 30% of the patients, respectively, still used analgesics.

Conclusions: In these older adults consulting their GP with back pain, 72% used analgesics at baseline. Despite a decrease in medication use during follow-up, at 3 and 6 months a considerable proportion still used analgesics.

Keywords: Analgesics; Back Pain; Older Adults.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Analgesics / therapeutic use*
  • Back Pain / drug therapy*
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Nonprescription Drugs / therapeutic use
  • Practice Patterns, Physicians'
  • Prospective Studies

Substances

  • Analgesics
  • Nonprescription Drugs