November 22, 2011

USA: Disparities: In the E.R., the Elderly Get Less Pain Relief

NEW YORK, NY / The New York Times / Research / November 21, 2011

By Nicholas Bakalar

Older people who go to an emergency room in pain are less likely to get medication for it than younger people with similar levels of distress, a new analysis has found.

A seven-year nationwide study of emergency room patient data has found that 49 percent of patients over age 75 were given pain medication, compared with slightly more than 65 percent of those under age 75. The study, which included data on more than 88,000 emergency room visits, appeared online last month in Annals of Emergency Medicine.
Elderly people who were cognitively impaired or otherwise unable to report pain were not included in the analysis, so that does not explain the finding.
Although the reasons for the difference are unclear, the authors suggest that emergency room personnel may be concerned about adverse effects of pain medications on the elderly, or they may pay more attention to diagnosis in older patients and less to pain relief.
“There are side effects of pain medications,” said Dr. Timothy Platts-Mills, the lead author of the study and an assistant professor of medicine at the University of North Carolina, Chapel Hill. “But in almost all cases, you can provide some pain relief for older adults by selecting appropriate medications or reducing doses.”
And, he added, doing so can have additional benefits, like allowing a patient to preserve mobility and functioning.
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