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Transdermal buprenorphine for the treatment of chronic noncancer pain in the oldest old.

Abstract：

CONTEXT:Chronic pain increases with age, and in the elderly, comorbidities and polypharmacotherapy make the choice of treatment for pharmacological pain control a complex matter. OBJECTIVES:We conducted a multicenter, prospective, observational study to evaluate the efficacy and safety of the buprenorphine transdermal delivery system (TDS) in elderly patients with chronic noncancer pain. The aim was to assess the cognitive and behavioral status of patients during treatment. METHODS:The study included 93 patients (69 women and 24 men); the mean age was 79.7 years, and in most cases, the pain was due to osteoarthritis. Almost three-quarters (74.2%) of the patients had suffered pain for more than 12 months. The treatment was buprenorphine TDS, starting from a dose of 17.5 μg/h. Outcomes were assessed using the Mini-Mental State Examination (MMSE), the 17-item Hamilton Depression scale (HAM-D 17), the Neuropsychiatric Inventory, the Barthel Index, the Short-Form Health Survey (SF-12), a verbal numeric rating scale, and the Cumulative Illness Rating Scale (CIRS). RESULTS:Buprenorphine treatment was associated with a decrease in pain severity without negative effects on the central nervous system. On the HAM-D scale, there were reductions in both the psychological and somatic scores. On the MMSE, values at the beginning and end of the study were comparable. Evaluation by SF-12 showed improvements in physical and mental status. CIRS values at baseline and at the end of the study were superimposable, indirectly confirming the tolerability and safety profile of the drug. CONCLUSION:Our experience confirms the analgesic activity and safety of buprenorphine TDS in the elderly. There was an improvement in mood and a partial resumption of activities, with no influence on cognitive and behavioral ability.

journal_name

J Pain Symptom Manage

journal_title

Journal of pain and symptom management

authors

Gianni W,Madaio AR,Ceci M,Benincasa E,Conati G,Franchi F,Galetti G,Nieddu A,Salani B,Zuccaro SM

doi

10.1016/j.jpainsymman.2010.06.015

subject

Has Abstract

pub_date

2011-04-01 00:00:00

pages

707-14

issue

eissn

0885-3924

issn

1873-6513

pii

S0885-3924(10)00966-8

journal_volume

pub_type

临床试验,杂志文章,多中心研究

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Transdermal buprenorphine for the treatment of chronic noncancer pain in the oldest old.