Pain treatment and its cost in old people with dementia: a descriptive analysis from the Registry of Dementias of Girona (ReDeGi)

Abstract

Background: Pain prevalence is high among elderly people, and equally prevalent in those with dementia. The aim of this study was to describe the use analgesics, as well as the cost of these treatments in old people with dementia. Methods: We used a cross-sectional design using 1186 cases registered by the Registry of Dementias of Girona from 2007 to 2008. All drugs were categorized following the Anatomic Therapeutic Chemical classification and grouped according to the World Health Organization (WHO) analgesic ladder steps. Descriptive statistical methods were used. Results: Analgesics were prescribed to 78.6% (95% CI, 76.2–81.0) of the registered cases. Of them, 80.6% (95% CI, 78.0–83.2) were treated following step 1 of the WHO analgesic ladder, 16.8% (95% CI, 14.4–19.3) following step 2 and 2.6% (95% CI, 1.5–3.6) following step 3. Pain treatment in old people with dementia had a cost of 42.1 € per patient and year, with no significant differences depending on the subtype of dementia. Conclusions: The use of analgesics in our sample was not associated to age or to dementia severity, which are themselves risk factors for increased pain. Moreover, no differences were detected depending on the subtype of dementia.

KEYWORDS: :

• analgesic
• WHO analgesic ladder
• pain
• dementia
• cost

The ReDeGi Group Consists of the Following Investigators:

1. Department of Neurology, Hospital Universitari Josep Trueta: Mar Castellanos, PhD; David Genís Batlle, MD; Jordi Gich, BPsych; Rosa Meléndez, MD; Albert Molins, MD; Lluís Ramió, MD; Joaquín Serena, PhD; Yolanda Silva, PhD.

2. Dementia Unit, Hospital Santa Caterina: Marta Hernández, BPsych; Saioa Lejarreta, MD; Manuela Lozano, BPsych; Immaculada Pericot, PhD; Joan Vilalta-Franch, PhD; Antoni Turon Estrada, PhD; Josefa Turbau, MD; Jordi Llinàs, BPsych; Secundino López-Pousa, PhD.

3. Dementia Unit, Hospital de Palamós: Elisabet Alsina, BSw; Rosa de Eugenio, MD; Erélido Hernández, MD; Margarita Flaqué, BPsych.

4. Neurology Department, Hospital de Figueres: Olga Carmona, MD; Marta Cullell, BPsych; Teresa Osuna, MD; Maria Aguirregomozcorta, MD; Maria del Mar Fernández, MD.

5. Neurology and Geriatrics Departments, Hospital d'Olot: Josep Bisbe, MD; Marta Linares, BPsych; Fabian Marquez Daniel, MD; Natalia Vallmajó, MD.

6. Neurology and Geriatrics Departments, Hospital de Blanes: Fernando Espada, MD; Teresa Casadevall, MD; Héctor Perkal, MD; Marta Viñas, MD.

7. Neurology Department; Hospital de Campdevànol: Isabel Casas, BPsych; Josefa Turbau, MD; Josep M Cuy, MD; Anna Manzano, MD.

8. Pharmacy Unit, Healh Region of Girona: Anna Maria Roig, BPharm; Joan Coromina, BPharm; Mònica Palacios Soto, BPharm.