[Controlled-release hydromorphone in elderly patients with severe pain of different etiologies. Results of an observational study].
BACKGROUND
Elderly patients (older than 65) do not always receive adequate analgesic treatment, or else they suffer from side effects of the administered opioid. An alternative is oral controlled-release hydromorphone, the efficacy and tolerability of which in patientswith cancer-related pain and pain of other genesis has been confirmed in clinical studies.


OBJECTIVE
A total of 2650 patients (effective group 2412 patients) average age 64.3 +/- 13.4 most of whom suffering from tumor-related (56.2%) or musculoskeletal (49.4%) pain were recruited to a multicenter observational study to investigate controlled-release hydromorphone administered mainly on an ambulatory basis. Pain intensity and quality of life were self-assessed by the patients and recorded in a questionnaire.


RESULTS
Pain intensity decreased by 64.3% from 7.0 initially to 2.5 at the final examination (0 = no pain, 10 = most severe pain). Quality of life improved by 51.9%. This corresponded to a self-assessed decrease of impairment of quality of life from 45.9 initially to 22.1 at the final examination (0 = no impairment, 70 = most severe impairment). Opioid-type side effects, documented before initiating treatment, decreased appreciably under treatment with hydromorphone. The efficacy and tolerability of the medication, as well as patient compliance, were assessed by the participating physicians as "very good" or "good".


CONCLUSIONS
Controlled-release, orally administered hydromorphone is well suited for the treatment of elderly patients with severe pain of different etiologies, in particular those with cancer pain. It is both effective and well tolerated, and has an appreciable positive impact on the patient's quality of life.
Junker
U
U
Leitender Arzt der Abteilung für spezielle Schmerztherapie und Palliativmedizin des Sana Klinikums, Remscheid.
Figge
V
V
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D003692:Delayed-Action Preparations; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D004091:Hydromorphone / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000503:physiopathology; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D003692:Delayed-Action Preparations; D004091:Hydromorphone