title: Use of a bisphosphonate (etidronate) to improve metastatic bone pain in three hospice patients.
abstract: OBJECTIVE
  This report investigates the association among the bisphosphonate etidronate and relief of metastatic bone pain. Maintaining cognitive function while providing adequate relief from metastatic bone pain can be particularly difficult in elderly patients.
  
  
  METHODS
  Case Series.
  
  
  METHODS
  Rural community dwellings (Carroll County, Maryland) and an urban nursing home (Baltimore, MD).
  
  
  METHODS
  One patient residing in a skilled nursing facility and two patients from a home hospice program (Carroll Hospice).
  
  
  METHODS
  Administration of 400 mg of etidronate in cases of refractory metastatic bone pain.
  
  
  METHODS
  Reduction in analgesic dosing, improvement in cognitive function, and subjective pain improvement.
  
  
  RESULTS
  Three cases are presented in which the use of the bisphosphonate etidronate allowed for a reduction in opiate use with improvement in pain control and preservation of cognitive function.
  
  
  CONCLUSIONS
  Etidronate and perhaps bisphosphonates, in general, should be considered in the management of refractory metastatic bone pain, particularly in the hospice population.
authors.affiliation: Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD 21218, USA.
authors.forename: F M
authors.initials: FM
authors.lastname: Gloth
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000150:complications* / Q000556:secondary; D012968:Etidronic Acid / Q000627:therapeutic use*; D005260:Female; D017051:Hospice Care; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000209:etiology
chemical_list: D012968:Etidronic Acid