223 Chronic pain is frequently under-treated among older people in Ireland: data from TILDA

Abstract

Abstract Background Chronic pain can have significant adverse effects on quality-of-life, functional status, and well-being in later life. Concerns exist regarding under-treatment of pain among older people, however. The aim of this study, therefore, is to ascertain the prevalence of chronic pain among older people in Ireland, including prescribed pharmacological treatment. Methods Participants ≥70 years at TILDA Wave 1 were asked ‘Are you often troubled with pain?’ and if yes, were then asked ‘How bad is it most of the time? Mild, moderate, or severe?’. Medication lists were examined by anatomical therapeutic chemical code for analgesics (N02), opioids (N02A), and non-opioid analgesics (N02B). Frailty was assessed by Fried Frailty Scale. Data was analysed descriptively. Chi-square tests assessed differences in binary variables; t-tests for continuous variables. Results Over 1/3 of participants (n = 2,308; mean 77 years; 53% female) reported chronic pain (839/2,308), with 10% (222/2,308) reporting severe pain. Over 60% of participants with chronic pain (517/839) reported pain made it difficult to complete day-to-day activities. Almost two thirds of participants with moderate–severe pain (407/618) were not prescribed analgesia. Participants with untreated chronic pain were more likely to be female (62% vs 52%, p < 0.001), have functional impairment (22% vs 13%, p < 0.001) and to be frail (14% vs 6%, p < 0.001). Over 98% of participants with untreated pain had contact with healthcare (GP practice or ED) in the preceding 12 months. Conclusion In this population-representative analysis, chronic pain affects 1/3 older people in Ireland, with 1/10 reporting severe pain. Chronic pain often limits day-to-day activities yet is frequently under-treated or not treated at all, particularly in frail, older females, despite contact with the healthcare service. It is imperative, therefore, that we empower older people to report chronic pain to a healthcare professional and we facilitate appropriate assessment and treatment of their pain.