[Increasing importance of opioids in geriatrics].
BACKGROUND
During the previous 20 years the prescription of opioids for medical use has increased steadily. Patients and professionals have great reservations about the use of opioids in the elderly. The aim of this study was to describe the changes in analgesic therapy in a geriatric clinic during the previous 10 years.


METHODS
The quality and quantity of prescriptions for opioids as well as the costs of the analgesic therapy in a large geriatric clinic between 1994 and 2003 were analyzed.


RESULTS
The use of opioids increased steadily from 0.72 mg per day and patient in 1994 to 9.50 mg in 2003 (1320%). The introduction of sustained release tilidine/naloxone and tramadol led to a change of the prescribed forms but only to a slight increase in the total consumption of these drugs. In 1994 the average daily cost of analgesic therapy was 15 cents per patient compared with 46 cents in 2003. The percentage of analgesics in the pharmacological budget increased from 5.6 to 10.8%.


CONCLUSIONS
Dealing with opioids should be a part of the training program for all members of the geriatric team. Analgesics have come to play an important role in the pharmacological budget at least in this geriatric clinic.
Schuler
M
M
Bethanien-Krankenhaus, Geriatrisches Zentrum an der Universität Heidelberg. mschuler@bethanien-heidelberg.de
Oster
P
P
D000368:Aged; D000701:Analgesics, Opioid / Q000191:economics / Q000627:therapeutic use*; D003365:Costs and Cost Analysis; D011307:Drug Prescriptions / Q000191:economics; D005283:Fentanyl / Q000191:economics / Q000627:therapeutic use; D005853:Geriatrics / Q000639:trends*; D005858:Germany; D006801:Humans; D009020:Morphine / Q000191:economics / Q000627:therapeutic use; D009270:Naloxone / Q000191:economics / Q000627:therapeutic use; D010098:Oxycodone / Q000191:economics / Q000627:therapeutic use; D014147:Tramadol / Q000191:economics / Q000627:therapeutic use
D000701:Analgesics, Opioid; D009270:Naloxone; D014147:Tramadol; D009020:Morphine; D010098:Oxycodone; D005283:Fentanyl