title: Improving the pharmacologic management of pain in older adults: identifying the research gaps and methods to address them.
abstract: OBJECTIVE
  There has been a growing recognition of the need for better pharmacologic management of chronic pain among older adults. To address this need, the National Institutes of Health Pain Consortium sponsored an "Expert Panel Discussion on the Pharmacological Management of Chronic Pain in Older Adults" conference in September 2010 to identify research gaps and strategies to address them. Specific emphasis was placed on ascertaining gaps regarding use of opioid and nonsteroidal anti-inflammatory medications because of continued uncertainties regarding their risks and benefits.
  
  
  METHODS
  Eighteen panel members provided oral presentations; each was followed by a multidisciplinary panel discussion. Meeting transcripts and panelists' slide presentations were reviewed to identify the gaps and the types of studies and research methods panelists suggested could best address them.
  
  
  RESULTS
  Fifteen gaps were identified in the areas of treatment (e.g., uncertainty regarding the long-term safety and efficacy of commonly prescribed analgesics), epidemiology (e.g., lack of knowledge regarding the course of common pain syndromes), and implementation (e.g., limited understanding of optimal strategies to translate evidence-based pain treatments into practice). Analyses of data from electronic health care databases, observational cohort studies, and ongoing cohort studies (augmented with pain and other relevant outcomes measures) were felt to be practical methods for building an age-appropriate evidence base to improve the pharmacologic management of pain in later life.
  
  
  CONCLUSIONS
  Addressing the gaps presented in the current report was judged by the panel to have substantial potential to improve the health and well-being of older adults with chronic pain.
authors.affiliation: Division of Geriatrics and Gerontology, Weill Cornell Medical Center, 525 East 68th Street, Box 39, New York, NY 10065, USA. mcr2004@med.cornell.edu
authors.forename: M Cary
authors.initials: MC
authors.lastname: Reid
authors.forename: David A
authors.initials: DA
authors.lastname: Bennett
authors.forename: Wen G
authors.initials: WG
authors.lastname: Chen
authors.forename: Basil A
authors.initials: BA
authors.lastname: Eldadah
authors.forename: John T
authors.initials: JT
authors.lastname: Farrar
authors.forename: Bruce
authors.initials: B
authors.lastname: Ferrell
authors.forename: Rollin M
authors.initials: RM
authors.lastname: Gallagher
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Hanlon
authors.forename: Keela
authors.initials: K
authors.lastname: Herr
authors.forename: Susan D
authors.initials: SD
authors.lastname: Horn
authors.forename: Charles E
authors.initials: CE
authors.lastname: Inturrisi
authors.forename: Salma
authors.initials: S
authors.lastname: Lemtouni
authors.forename: Yu Woody
authors.initials: YW
authors.lastname: Lin
authors.forename: Kaleb
authors.initials: K
authors.lastname: Michaud
authors.forename: R Sean
authors.initials: RS
authors.lastname: Morrison
authors.forename: Tuhina
authors.initials: T
authors.lastname: Neogi
authors.forename: Linda L
authors.initials: LL
authors.lastname: Porter
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Solomon
authors.forename: Michael
authors.initials: M
authors.lastname: Von Korff
authors.forename: Karen
authors.initials: K
authors.lastname: Weiss
authors.forename: James
authors.initials: J
authors.lastname: Witter
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Zacharoff
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000698:Analgesia / Q000379:methods* / Q000592:standards*; D000700:Analgesics / Q000592:standards* / Q000627:therapeutic use*; D035843:Biomedical Research / Q000639:trends; D019317:Evidence-Based Medicine / Q000592:standards; D006801:Humans; D010148:Intractable Pain / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology
chemical_list: D000700:Analgesics