The American Medical Directors Association has determined that short-acting Opioids such as propoxyphene increase the risk of fractures sevenfold! What does this mean to you?  If your facility is admitting residents who require pain management interventions it may be beneficial to take a closer look at what medications have been prescribed in the acute care setting. 

The study was performed on elderly patients who were being treated with short acting opioids for arthritis pain versus using long-acting medications.  The study revealed that there was “a sevenfold increase of fracture in the first two weeks of treatment for persons taking short-acting opioids”. 

So think about it, you admit a resident to your facility from the hospital, what are the chances that the resident is receiving medication for pain?  Acute care settings do a great job diagnosing, stabilizing and managing elderly patients on a short term basis.  That said, we are admitting residents with orders for medications that may not be the best choice for long term pain management. 

As you look at your admission process please be sure that medications are reviewed closely and that if there are medications ordered that are not recommended for use in the elderly the physician is made aware.  There are resources available to assist in this process (PDR, BEERs list, etc.) and our pharmacy provider should also be available as a resource.

To read the AMDA article in its’ entirety, please refer to the article written by Bruce Jancin and published in the January 2011 edition of “Caring for the Ages”, the AMDA monthly newspaper for Long-Term Care Practitioners.