Pharmacological management of chronic non-cancer pain in frail older people

Chronic non-cancer pain is a common problem among older people and has a significant impact on their quality of life. Medical comorbidities and polypharmacy are often additional challenges in managing these patients. Appropriate assessment of chronic non-cancer pain is important for the development of a patient-centred, goal-directed management plan. When assessing patients with cognitive impairment, modified communication strategies and validated pain assessment tools can be useful. The quantity and quality of the evidence supporting individual drugs in the management of chronic non-cancer pain varies and studies focused on frail older people are limited. Caution is generally advised when introducing drugs and escalating the doses. Drugs that are not effective should be stopped. A shared decision-making approach is advised for deprescribing analgesics used for chronic non-cancer pain.

Automated summary

Chronic non-cancer pain is common in older people and has a significant impact on their quality of life. Managing this pain can be challenging due to medical comorbidities and polypharmacy. It is important to assess the pain appropriately and use validated tools to guide treatment decisions. Caution is advised when prescribing drugs, especially for frail older people, and a shared decision-making approach is recommended for deprescribing analgesics.