The impact of the treatment of chronic pain treatment with transdermal buprenorphine on functional performance and risk of falls in elderly people diagnosed with osteoarthritis

Abstract

The aim of the study was to evaluate the impact of transdermal buprenorphine on overall functional fitness and the risk for falls in the treatment of chronic pain in elderly patients diagnosed with osteoarthritis. Transdermal buprenorphine was used for 10 days in 60 patients over 64 years old in the treatment of severe chronic pain caused by osteoarthritis. Patients were randomly assigned to 3 groups with a starting dose of 8.75 µg/h, 17.5 µg/h, and 35 µg/h, respectively. On day 1 of the study, the Barthel Index, Instrumental Activities of Daily Living (IADL), Mini–Mental State Examination (MMSE), and the Tinetti balance and gait test were used. On the final day of the study, the Tinetti balance and gait test and the Barthel Index were used again. Pain intensity was evaluated every day with the Brief Pain Inventory – Short Form. No differences in IADL scores between patient groups in baseline assessment were found. An improvement in the Barthel Index overall scores was obtained in all patients with no differences between patient groups. An improvement for both balance and gait in all patient groups of the Tinetti test was found. Regarding balance and overall results, a more significant improvement in group 3 compared to groups 1 and 2 was observed. Transdermal buprenorphine provided satisfactory analgesia regardless of the starting dose of the drug with better toleration of lower initial doses: 8.75 µg/h and 17.5 µg/h compared to a starting dose of 35 µg/h. The treatment of elderly patients with severe chronic pain induced by osteoarthritis with different initial doses of transdermal buprenorphine improved overall physical fitness and reduced the risk for falls. The treatment resulted in satisfactory analgesia with less adverse effects in patients who started with lower initial lower doses of transdermal buprenorphine.