title: [Pain medication in nursing home residents with and without cancer. Most frequently with metamizole].
abstract: BACKGROUND
  Pain is a highly prevalent symptom in nursing home residents. The analgesic pharmacotherapy of older adults is associated with challenges; however, studies from Germany examining the prescription pattern of analgesics in nursing home residents are rare.
  
  
  OBJECTIVE
  This study was carried out to examine the prescription of analgesics in nursing home residents with and without the diagnosis of cancer.
  
  
  METHODS
  Using health insurance claims data persons aged ≥ 65 years who were newly admitted to a nursing home between 2004 and 2009 and who survived at least the first 90 days after admission were included in the study. Cancer was identified by outpatient diagnoses of malignant neoplasms (ICD-10: C00-C97). Prescription drugs within the first 90 days after admission to a nursing home were analyzed which means that aspirin and acetaminophen were not taken into account.
  
  
  RESULTS
  A total of 5549 nursing home residents were included, who were on average 81.5 years old (56.8 % females). More than half (53.5 %) were assigned to care level I and 781 (14.1 %) were diagnosed with cancer. The study cohort received on average 7.8 different medications (with vs. without cancer: 8.6 vs. 7.6, respectively) and 43.8 % had prescriptions for analgesics (with vs. without cancer: 52.5 vs. 42.3 %, respectively). A total of 37.1 % were taking WHO step 1 analgesics (step 2: 11.4 % and step 3: 9.2 %). The proportion of persons receiving metamizole (dipyrone) was 28.3 % (with vs. without cancer: 35.6 vs. 27.1 %, respectively). Regarding all prescriptions, metamizole was by far the most frequently prescribed medication in nursing homes followed by melperone and omeprazole.
  
  
  CONCLUSIONS
  Approximately one third of nursing home residents received metamizole and most were long-term prescriptions. Considering that metamizole is associated with potentially life-threatening adverse effects, caution is indicated particularly when prescribed over long periods.
authors.affiliation: Abteilung Gesundheitsökonomie, Gesundheitspolitik und Versorgungsforschung, Zentrum für Sozialpolitik, Universität Bremen, Mary-Somerville-Straße 3, 28359, Bremen, Deutschland, jana.schulze@uni-bremen.de.
authors.forename: J
authors.initials: J
authors.lastname: Schulze
authors.forename: M H
authors.initials: MH
authors.lastname: Freitag
authors.forename: G
authors.initials: G
authors.lastname: Glaeske
authors.forename: G
authors.initials: G
authors.lastname: Schmiemann
authors.forename: F
authors.initials: F
authors.lastname: Hoffmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use*; D002090:Butyrophenones / Q000627:therapeutic use; D000072716:Cancer Pain / Q000145:classification / Q000188:drug therapy*; D015331:Cohort Studies; D004177:Dipyrone / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany; D006302:Health Services Research; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009735:Nursing Homes; D009853:Omeprazole / Q000627:therapeutic use; D010147:Pain Measurement; D010148:Intractable Pain / Q000145:classification / Q000188:drug therapy*
chemical_list: D000700:Analgesics; D002090:Butyrophenones; D004177:Dipyrone; C008522:metylperon; D009853:Omeprazole