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

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Harvard

Sørensen, AMS, Tarp, S, Johannsen, P, Lolk, A, Bandak, E, Pedersen, H, Saxtrup, N, Kallehauge, H, Solem, EJ & Christensen, MB 2019, 'Analgesics use and withdrawal in people with dementia - a register-based Danish study and a systematic review' Danish Medical Journal, vol. 66, no. 12, pp. A5578.

APA

Sørensen, A. M. S., Tarp, S., Johannsen, P., Lolk, A., Bandak, E., Pedersen, H., ... Christensen, M. B. (2019). Analgesics use and withdrawal in people with dementia - a register-based Danish study and a systematic review. Danish Medical Journal, 66(12), A5578.

CBE

Sørensen AMS, Tarp S, Johannsen P, Lolk A, Bandak E, Pedersen H, Saxtrup N, Kallehauge H, Solem EJ, Christensen MB. 2019. Analgesics use and withdrawal in people with dementia - a register-based Danish study and a systematic review. Danish Medical Journal. 66(12):A5578.

MLA

Vancouver

Author

Sørensen, Anne Mette Skov ; Tarp, Simon ; Johannsen, Peter ; Lolk, Annette ; Bandak, Elisabeth ; Pedersen, Hanne ; Saxtrup, Niels ; Kallehauge, Hanne ; Solem, Espen Jimenez ; Christensen, Mikkel Bring. / Analgesics use and withdrawal in people with dementia - a register-based Danish study and a systematic review. In: Danish Medical Journal. 2019 ; Vol. 66, No. 12. pp. A5578.

Bibtex

@article{047bb09e24d640349cb6da944eea1322,
title = "Analgesics use and withdrawal in people with dementia - a register-based Danish study and a systematic review",
abstract = "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.",
author = "S{\o}rensen, {Anne Mette Skov} and Simon Tarp and Peter Johannsen and Annette Lolk and Elisabeth Bandak and Hanne Pedersen and Niels Saxtrup and Hanne Kallehauge and Solem, {Espen Jimenez} and Christensen, {Mikkel Bring}",
note = "Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.",
year = "2019",
month = "12",
language = "English",
volume = "66",
pages = "A5578",
journal = "Danish Medical Bulletin (Online)",
issn = "1603-9629",
publisher = "Almindelige Danske Laegeforening",
number = "12",

}

RIS

TY - JOUR

T1 - Analgesics use and withdrawal in people with dementia - a register-based Danish study and a systematic review

AU - Sørensen, Anne Mette Skov

AU - Tarp, Simon

AU - Johannsen, Peter

AU - Lolk, Annette

AU - Bandak, Elisabeth

AU - Pedersen, Hanne

AU - Saxtrup, Niels

AU - Kallehauge, Hanne

AU - Solem, Espen Jimenez

AU - Christensen, Mikkel Bring

N1 - Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

PY - 2019/12

Y1 - 2019/12

N2 - 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.

AB - 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.

M3 - Review

VL - 66

SP - A5578

JO - Danish Medical Bulletin (Online)

JF - Danish Medical Bulletin (Online)

SN - 1603-9629

IS - 12

ER -

ID: 59267108