Pharmacological management of persistent pain in older patients

Objectives: The purpose of this manuscript is to foster understanding of the unique attributes of aging as they relate to the treatment of persistent pain in order to improve care of older patients. Methods: A thorough review of pertinent recent literature, including clinical guidelines, provided the materials from which this synthesis is drawn. Results: Several unique attributes of aging are identified that should be taken into account in order to provide safe and effective pharmacotherapy for older patients with persistent pain. Discussion: Adherence to contemporary clinical guidelines should serve to promote improved outcomes in older patients who suffer from ongoing and debilitating pain. Since outcomes studies are lacking, attention to principles of care as they apply to this particular population is advised. Since each patient's experience and response to drug therapy will be unique, individualized assessment that incorporates an analysis of the patient's physiological state (co-morbidities and concurrent drug therapies), a determination of realistic goals, and monitoring of outcomes on a regular basis will provide the optimum balance between benefits and risks of analgesic pharmacotherapy.