title: Factors associated with suboptimal analgesic use in community-dwelling elderly.
abstract: OBJECTIVE
  To examine patterns and factors associated with overall and suboptimal analgesic use among community-dwelling elderly.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Five-county urban and rural region in Piedmont, NC.
  
  
  METHODS
  A stratified random sample from the Duke Established Populations for Epidemiologic Studies of the Elderly of 3973 participants aged 65 years or older.
  
  
  METHODS
  Use of any analgesic medication, suboptimal analgesic use (taking 2 or more analgesics from the same class, using 3 or more analgesics concurrently, or use of an analgesic that has a major interaction with another drug).
  
  
  RESULTS
  Analgesics were used by 60.4% of the participants. Use was more likely for those who had physical functional impairment, a history of cardiovascular disease, one or more health visits in the previous year, or were female. Use was less likely for older participants and for African-Americans with adequate financial status. Suboptimal use occurred in 9.2% of analgesic users. Therapeutic duplication was more likely in those who were depressed, needed help with basic activities of daily living, or used alcohol, and was less likely in those with adequate financial status. Multiple analgesic use was more likely in those who were depressed, had impaired physical functional status, had one or more health visits in the previous year, were African-American (of either sex), or were white women. Only two persons had a potential major analgesic-drug interaction.
  
  
  CONCLUSIONS
  Suboptimal analgesic use is common in community-dwelling elderly, and its risk in consistently increased in those who are depressed or have impaired physical functional status.
authors.affiliation: Department of Medicine, Duke University Medical Center, Durham, NC, USA.
authors.forename: J T
authors.initials: JT
authors.lastname: Hanlon
authors.forename: G G
authors.initials: GG
authors.lastname: Fillenbaum
authors.forename: S A
authors.initials: SA
authors.lastname: Studenski
authors.forename: T
authors.initials: T
authors.lastname: Ziqubu-Page
authors.forename: W E
authors.initials: WE
authors.lastname: Wall
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D003863:Depression; D005260:Female; D016330:Frail Elderly; D006306:Health Surveys; D006801:Humans; D008297:Male; D009657:North Carolina; D012424:Rural Population; D012646:Self Administration; D012737:Sex Factors; D012959:Socioeconomic Factors; D014505:Urban Population
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal