Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital

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

Research output: Contribution to journalReviewResearchpeer-review

  1. Trends of ankyloglossia and lingual frenotomy in hospital settings among children in Denmark

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Distribution of risk alleles in patients with age-related macular degeneration

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Danish expanded newborn screening is a successful preventive public health programme

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Everolimus as adjunctive treatment in tuberous sclerosis complex-associated epilepsy in children

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Protocol for a randomised clinical trial of transoral ultrasound versus standard of care in the diagnosis of peritonsillar abscess

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Anne Mette Skov Sørensen
  • Simon Tarp
  • Peter Johannsen
  • Annette Lolk
  • Elisabeth Bandak
  • Hanne Pedersen
  • Niels Saxtrup
  • Hanne Kallehauge
  • Espen Jimenez Solem
  • Mikkel Bring Christensen
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
Issue number12
Pages (from-to)A5578
Publication statusPublished - Dec 2019

ID: 59267108