Pain Treatment in Elderly Population with Cancer Diagnosis

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2020

Authors

Rasu, Rafia
Bhachawat, Neal

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IRBexempt#2020-013.Purpose:Cancer incidence increases with age. One prevalent symptom of cancer is chronic pain,which is frequently treated with opioids and other pain medications. As patients age, physiologic changes occur which alter drug pharmacokinetics, making elderly patients susceptible to drug adverse effects. Falls are a leading cause of death in the elderly and seniors taking opioids are 5-times more likely to suffer one. Our goal is to identify pain treatment in elderly cancer patients, note patient-specific factors and any adverse events.Methods:A cross-sectional study analyzing pain prescriptions to manage acute or chronic pain associated with cancer in patients, age 65+. The population data will be compiled from the National Ambulatory Medical Care Survey (NAMCS)database provided by CDC. Diagnosis was based on ICD-9/10codes and medication codes identified by NAMCS for patient visits.Results:Reported in the NAMCSdatabase between2006and2017 was 276,166,738(weighted frequencies) cancer patient visits with pain medication treatment. Data consisted of 71%white, 53%female. There was almost a 2-fold increase in patient visits from the 2006-2008data period(18%), to the 2009-2011data period(31%). Peak trend was in 2009-2011(p value < 0.001). Cancer diagnoses varied but included:6%prostate,2%colon,5%breast, 4%lung cancers. Out of the 276,166,738 visits,3%were taking opioids,8%mixed opioids,2%nsaids,3%apap and 84%other pain medications. Population regionally:37%South,23%Midwest,22%West,18%Northeast(p value< 0.05). Interestingly, 83% experienced a fall as an adverse event. Conclusion:A notable amount of fall events recorded in this population, greater than the CDC estimated national average;we recommend further assessing this risk. Identifed regional variation: South having majority of pain prescriptions and Northeast havingthe fewest.

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