Non-pharmacological interventions for managing pain in community-dwelling older adults
Pain is a complex and common issue within older adults. This complexity can be a direct result of comorbidities and the subsequent polypharmacy. The effective control of pain in older adults needs more than just pharmacological management. Non-pharmacological interventions have been demonstrated to be beneficial when combined with pain medications. This commentary critically appraises a systematic review that examines the effectiveness of non-pharmacological interventions for the management of pain in community dwelling older adults.
Pain in the older adults is a common problem, with a prevalence of 28% to 60% (Chung and Wong, 2007). This population has many aspects that need to be taken into consideration when treating pain, both acute and chronic (Ali et al, 2018). Specifically, comorbidities can restrict the use of many common pain medications (Ali et al, 2018). The changes in the pharmacokinetics and pharmaco-dynamics make it difficult to achieve a balance between the appropriate dosage for effective pain relief and the management of side effects (Chung and Wong, 2007). The effective control of pain in older adults needs more than just pharmacological management (Noroozian et al, 2018). Non-pharmacological interventions have been shown to have potential when combined with pain medication (Shropshire et al, 2019). However, previous reviews in this area included methodologically weak studies and are becoming out of date (Tang et al, 2019). The systematic review by Tang et al (2019) (Box 1) aimed to assess the effectiveness, suitability and sustainability of non-pharmacological interventions for the management of pain in community-dwelling older adults.
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