Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Analgesics use and withdrawal in people with dementia - a register-based Danish study and a systematic review

Research output: Contribution to journalReviewResearchpeer-review

  1. Post-operative recovery is not a limiting factor for adjuvant chemotherapy in patients undergoing surgery for colorectal cancer

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Providing targeted healthcare services for immigrants with complex health needs

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Multivitamin intake does not affect the risk of preterm and very preterm birth

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Time from injury to arrival at the trauma centre in patients undergoing interhospital transfer

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Face masks for the prevention of COVID-19 - Rationale and design of the randomised controlled trial DANMASK-19

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Glucagon-like peptide-1 receptor regulation of basal dopamine transporter activity is species-dependent

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Glucose-dependent Insulinotropic Polypeptide (GIP) reduces bone resorption in patients with type 2 diabetes

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Total burden of disease in cancer patients at diagnosis-a Danish nationwide study of multimorbidity and redeemed medication

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Prevalence of polypharmacy in Denmark

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Perfusion in bone marrow lesions assessed on DCE-MRI and its association with pain in knee osteoarthritis: a cross-sectional study

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

INTRODUCTION: Pain assessment in people with dementia is difficult, and withdrawal of analgesics may allow for assessment of treatment efficacy whilst decreasing pill burden, adverse events and interactions. We aimed to describe the use of analgesics among elderly in Denmark and to compile the evidence for withdrawal of analgesics among people with dementia.

METHODS: With respect to analgesics use, we employed data from national registries on the analgesic prescription use (opioids, nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen) in 2017 among elderly people with and without dementia. Trial evidence was produced by performing a systematic search in MEDLINE, Embase and Cinahl for trials evaluating withdrawal of analgesics in people with dementia.

RESULTS: Opioids were prescribed more frequently (p = 0.026) and NSAIDs less frequently (p = 0.026) to people with dementia. With respect to trial evidence, we identified two studies: An observational cross-over study (n = 3) reporting acetaminophen withdrawal leading to increases in pain frequency and duration, and a cluster-randomised clinical trial (n = 352) reporting changes in mobilization-observation-behaviour-intensity-dementia-2 (MOBID-2) pain score during a four-week withdrawal period (acetaminophen, opioids and/or pregabaline) from a mean ± standard deviation of 2.3 ± 2.1 to 2.9 ± 2.6 compared with 3.5 ± 2.6 to 3.5 ± 2.5 in the control group.

CONCLUSIONS: In Denmark, use of opioids is higher in elderly with dementia compared to elderly without dementia. The evidence suggests that withdrawal of analgesics may aggravate pain but increases in pain scores may be of little clinical relevance in most people. Clinical trials investigating analgesics withdrawal are warranted.

Original languageEnglish
JournalDanish Medical Journal
Volume66
Issue number12
Pages (from-to)A5578
ISSN1603-9629
Publication statusPublished - Dec 2019

ID: 59267108