Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-02T19:24:43.983Z Has data issue: false hasContentIssue false
  • English
  • Français

Older Adults Living with Osteoarthritis: Examining the Relationship of Age and Gender to Medicine Use*

Published online by Cambridge University Press:  31 July 2012

Judith E. Fisher ,
Peri J. Ballantyne  and
Gillian A. Hawker
Judith E. Fisher*
Affiliation:
Dalhousie University
Peri J. Ballantyne
Affiliation:
Trent University
Gillian A. Hawker
Affiliation:
University of Toronto
*
†Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Judith E. Fisher, Ph.D. College of Pharmacy Dalhousie University 5968 College St. Halifax NS B3H3J5 ([email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Osteoarthritis (OA) in older adults is a prevalent chronic condition associated with substantial pain and disability. Oral analgesic use is a central component of symptom management. Medication use in this population, however, is complex and must balance the need for symptom control with drug safety concerns. Our study focus was to illustrate and discuss the variability in the medications used to manage OA-related symptoms. We analysed data from a sample of community-dwelling persons aged 55 and older with hip or knee arthritis to examine social and medical factors associated with reported variation in OA drugs. A key finding is that drug types used by OA patients vary by age and gender, independent of disease, and medical and social context. Possible explanations related to patient and professional preferences are considered.

Résumé

L’ostéoarthrite (OA) chez les personnes âgées constitue une condition chronique et répandue associée à des douleurs importantes d’invalidité. L’utilisation d’analgésiques par voie orale est un élément central de la gestion des symptômes. L’utilisation de médicaments par cette population, cependant, est complexe et la nécessité de contrôler les symptômes doivent être mis en balance avec les préoccupations concernant la sécurité des médicaments. Notre étude s’est concentrée à illustrer et à explorer les variations entre divers médicaments différents utilisés pour gérer les symptômes liés à l’ostéoarthrite. Nous avons analysé les données provenant d’un échantillon de personnes âgées de 55 ans et plus, qui vivent dans les communautés, et qui souffrent d’arthrite de la hanche ou du genou pour examiner les facteurs sociaux et médicaux associés à la variation dans les médicaments rapporté. Une conclusion principale est que les types de médicaments utilisés par les patients atteints d’ostéoarthrite varient selon l’âge et le sexe, indépendamment de la maladie et du contexte médical et social. Les explications possibles ont été considérés comme relatives aux préférences des patients et des professionnels.

Keywords

ostéoarthriteutilisation de médicamentspersonnes âgéesvieillissementsexeosteoarthritismedication useolder adultsaginggender
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 31 , Issue 3 , September 2012 , pp. 323 - 333
Copyright
Copyright © Canadian Association on Gerontology 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Judith E. Fisher received grant support from the Canadian Institutes of Health Research (CIHR) and Social Sciences and Humanities Research Council of Canada (SSHRC). Peri J. Ballantyne received grant support from SSHRC. Gillian A. Hawker received grant support from CIHR.

References

Abernethy, D.R. (1999). Aging effects on drug disposition and effect. Geriatric Nephrology and Urology, 9(1), 15–19.Google Scholar
Arber, S., McKinlay, J., Adams, A., Marceau, L., Link, C., & O’Donnell, A. (2006). Patient characteristics and inequalities in doctors’ diagnostic and management strategies relating to CHD: A video-simulation experiment. Social Science & Medicine, 62(1), 103–115. doi:10.1016/j.socscimed.2005.05.028.Google Scholar
Ballantyne, P.J., Gignac, M.A., & Hawker, G.A. (2007). A patient-centered perspective on surgery avoidance for hip or knee arthritis: Lessons for the future. Arthritis and Rheumatism, 57(1), 27–34. doi:10.1002/art.22472.Google Scholar
Bellamy, N., Buchanan, W. W., Goldsmith, C. H., Campbell, J., & Stitt, L. W. (1988). Validation study of WOMAC: A health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. The Journal of Rheumatology, 15(12), 1833–184.Google Scholar
Bijlsma, J.W. (2002). Analgesia and the patient with osteoarthritis. American Journal of Therapeutics, 9(3), 189–197.CrossRefGoogle ScholarPubMed
Borkhoff, C.M., Hawker, G.A., Kreder, H.J., Glazier, R.H., Mahomed, N.N., & Wright, J.G. (2008). The effect of patients’ sex on physicians’ recommendations for total knee arthroplasty. Canadian Medical Association Journal, 178(6), 681–687. doi:10.1503/cmaj.071168.Google Scholar
Bouvy, M.L., Heerdink, E.R., Leufkens, H.G., & Hoes, A.W. (2003). Predicting mortality in patients with heart failure: A pragmatic approach. Heart, 89(6), 605–609.Google Scholar
Buckwalter, J.A., Saltzman, C., & Brown, T. (2004). The impact of osteoarthritis – implications for research. Clinical Orthopaedics and Related Research, October (427 Suppl.), S6–S15. doi:10.1097/01.blo.0000143938.30681.9d.CrossRefGoogle ScholarPubMed
Courtney, P., & Doherty, M. (2002). Key questions concerning paracetamol and NSAIDs for osteoarthritis. Annals of Rheumatic Diseases, 61, 767–773.CrossRefGoogle ScholarPubMed
Dworkin, R.H., O’Connor, A.B., Backonja, M., Farrar, J.T., Finnerup, N.B., Jensen, T.S., et al. . (2007). Pharmacologic management of neuropathic pain: Evidence-based recommendations. Pain, 132(3), 237–251. doi:10.1016/j.pain.2007.08.033.Google Scholar
Ellis, S.R., & Morrison, T.G. (2005). Stereotypes of ageing: Messages promoted by age-specific paper birthday cards available in Canada. International Journal of Aging & Human Development, 61(1), 57–73.CrossRefGoogle ScholarPubMed
Foss, C., & Sundby, J. (2003). The construction of the gendered patient: Hospital staff’s attitudes to female and male patients. Patient Education and Counseling, 49(1), 45–52.Google Scholar
Fowler, R.A., Sabur, N., Li, P., Juurlink, D.N., Pinto, R., Hladunewich, M.A., et al. . (2007). Sex-and age-based differences in the delivery and outcomes of critical care. Canadian Medical Association Journal, 177(12), 1513–1519. doi:10.1503/cmaj.071112.CrossRefGoogle ScholarPubMed
Gignac, M. A., Cott, C., & Badley, E. M. (2000). Adaptation to chronic illness and disability and its relationship to perceptions of independence and dependence. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 55(6), P362–72.Google Scholar
Green, C.A., & Pope, C.R. (1999). Gender, psychosocial factors and the use of medical services: A longitudinal analysis. Social Science & Medicine, 48(10), 1363–1372.CrossRefGoogle ScholarPubMed
Griffin, M.R., Yared, A., & Ray, W.A. (2000). Nonsteroidal antiinflammatory drugs and acute renal failure in elderly persons. American Journal of Epidemiology, 151(5), 488–496.Google Scholar
Hawker, G.A., Wright, J.G., Coyte, P.C., Williams, J.I., Harvey, B., Glazier, R., et al. . (2000). Differences between men and women in the rate of use of hip and knee arthroplasty. The New England Journal of Medicine, 342(14), 1016–1022.Google Scholar
Health Canada. (2003). Arthritis in Canada. An ongoing challenge. No. Cat. # H39-4/14-2003E). Ottawa, Ontario, Canada: Health Canada.Google Scholar
Jaccard, J. (2001). Interaction effects in logistic regression. Thousand Oaks, CA: Sage.CrossRefGoogle Scholar
Langman, M.J. (2003). Adverse effects of conventional non-steroidal anti-inflammatory drugs on the upper gastrointestinal tract. Fundamental & Clinical Pharmacology, 17(4), 393–403.CrossRefGoogle ScholarPubMed
Lewis, S.C., Langman, M.J., Laporte, J.R., Matthews, J.N., Rawlins, M.D., & Wiholm, B.E. (2002). Dose-response relationships between individual nonaspirin nonsteroidal anti-inflammatory drugs (NANSAIDs) and serious upper gastrointestinal bleeding: A meta-analysis based on individual patient data. British Journal of Clinical Pharmacology, 54(3), 320–326.Google Scholar
Lumme-Sandt, K., & Virtanen, P. (2002). Older people in the field of medication. Sociology of Health Illness, 24(3), 285–304.Google Scholar
O’Brien, R., Hunt, K., & Hart, G. (2005). ‘It’s caveman stuff, but that is to a certain extent how guys still operate’: Men’s accounts of masculinity and help seeking. Social Science & Medicine, 61(3), 503–516. doi:10.1016/j.socscimed.2004.12.008.Google Scholar
Podichetty, V.K., Mazanec, D.J., & Biscup, R.S. (2003). Chronic non-malignant musculoskeletal pain in older adults: Clinical issues and opioid intervention. Postgraduate Medical Journal, 79(937), 627–633.Google Scholar
Pope, J.E., Anderson, J.J., & Felson, D.T. (1993). A meta-analysis of the effects of nonsteroidal anti-inflammatory drugs on blood pressure. Archives of Internal Medicine, 153(4), 477–484.CrossRefGoogle ScholarPubMed
Pound, P., Britten, N., Morgan, M., Yardley, L., Pope, C., Daker-White, G., et al. . (2005). Resisting medicines: A synthesis of qualitative studies of medicine taking. Social Science & Medicine, 61(1), 133–155. doi:10.1016/j.socscimed.2004.11.063.Google Scholar
Sale, J.E., Gignac, M., & Hawker, G. (2006). How “bad” does the pain have to be? A qualitative study examining adherence to pain medication in older adults with osteoarthritis. Arthritis and Rheumatism, 55(2), 272–278. doi:10.1002/art.21853.Google Scholar
Schlansky, B., & Hwang, J.H. (2009). Prevention of nonsteroidal anti-inflammatory drug-induced gastropathy. Journal of Gastroenterology, 44(Suppl 19), 44–52. doi:10.1007/s00535-008-2275-5.CrossRefGoogle ScholarPubMed
Shumway-Cook, A., Ciol, M.A., Gruber, W., & Robinson, C. (2005). Incidence of and risk factors for falls following hip fracture in community-dwelling older adults. Physical Therapy, 85(7), 648–655.Google Scholar
Sontag, S. (1997). The double standard of aging. In Pearsall, M. (Ed.), The other within us. Feminist explorations of women and aging (pp. 19–24). Boulder, CO: Westview Press.Google Scholar
Sturmer, T., Elseviers, M.M., & De Broe, M.E. (2001). Nonsteroidal anti-inflammatory drugs and the kidney. Current Opinion in Nephrology and Hypertension, 10(2), 161–163.Google Scholar
Tudiver, F., & Talbot, Y. (1999). Why don’t men seek help? Family physicians’ perspectives on help-seeking behavior in men. The Journal of Family Practice, 48(1), 47–52.Google ScholarPubMed
van Wijk, C.M., & Kolk, A.M. (1997). Sex differences in physical symptoms: The contribution of symptom perception theory. Social Science & Medicine, 45(2), 231–246.CrossRefGoogle ScholarPubMed
Whelton, A. (1999). Nephrotoxicity of nonsteroidal anti-inflammatory drugs: Physiologic foundations and clinical implications. The American Journal of Medicine, 106(5B), 13S–24S.Google Scholar
Wolfe, M.M., Lichtenstein, D.R., & Singh, G. (1999). Gastrointestinal toxicity of nonsteroidal antiinflammatory drugs. The New England Journal of Medicine, 340(24), 1888–1899. doi:10.1056/NEJM199906173402407.Google Scholar
Zhang, W., Moskowitz, R.W., Nuki, G., Abramson, S., Altman, R.D., Arden, N., et al. . (2007). OARSI recommendations for the management of hip and knee osteoarthritis, part I: Critical appraisal of existing treatment guidelines and systematic review of current research evidence. Osteoarthritis and Cartilage, 15(9), 981–1000. doi:10.1016/j.joca.2007.06.014.Google Scholar
Zhang, W., Moskowitz, R.W., Nuki, G., Abramson, S., Altman, R.D., Arden, N., et al. . (2008). OARSI recommendations for the management of hip and knee osteoarthritis, part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis and Cartilage, 16(2), 137–162. doi:10.1016/j.joca.2007.12.013.CrossRefGoogle ScholarPubMed
Zhang, W., Nuki, G., Moskowitz, R.W., Abramson, S., Altman, R.D., Arden, N.K., et al. . (2010). OARSI recommendations for the management of hip and knee osteoarthritis: Part III: Changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthritis and Cartilage, 18(4), 476–499. doi:10.1016/j.joca.2010.01.013.Google Scholar