Older adult osteoarthritis pain management: results from the 2008 National Ambulatory Medical Care Survey.
OBJECTIVE
To describe practitioners' prescription of recommended initial osteoarthritis (OA) pain treatments for older adults.


METHODS
A secondary data analysis was conducted with the 2008 National Ambulatory Medical Care Survey (NAMCS) that was completed by practitioners in ambulatory medical care settings. Of the 28,741 office visits, 9314 were by adult patients age 60 or older, and 871 of those visits involved a painful joint. Only 128 were also by people with practitioner-documented OA. Of those 128 visits, 21 (16.1%) were prescribed exercise and/or acetaminophen and were not prescribed non-steroidal anti-inflammatory agents (NSAIDS). No complementary alternative medical treatments were prescribed. Older adults with and without documented OA had a mean of at least four office visits with the practitioner during the past year.


CONCLUSIONS
OA may be under-diagnosed, under-reported, or overshadowed by co-morbid medical conditions. Older adults with persistent OA pain are at increased risk for adverse events from prescribed NSAIDs. Safe and effective multimodal pain treatments need to be prescribed for older adults with persistent OA pain.


CONCLUSIONS
Referral to a rheumatologist or pain management specialist should be considered when pain intensity and/or pain interference with daily activities remains moderate or greater.
University of Connecticut, 231 Glenbrook Road, Storrs, CT 06269-2026, USA. deborah.mcdonald@uconn.edu
Deborah D
DD
McDonald
Stephen
S
Walsh
D000082:Acetaminophen; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D003131:Combined Modality Therapy; D015897:Comorbidity; D015444:Exercise; D005260:Female; D019983:Guideline Adherence; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000453:epidemiology / Q000628:therapy*; D059408:Pain Management / Q000379:methods*; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000706:statistics & numerical data; D012017:Referral and Consultation; D014481:United States / Q000453:epidemiology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen