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Medical News & Perspectives
July 1, 2009

New Pain Guideline for Older Patients

JAMA. 2009;302(1):19. doi:10.1001/jama.2009.887

Physicians treating patients aged 75 years or older for chronic pain should avoid using nonsteroidal anti-inflammatory drugs (NSAIDs), according to an updated guideline issued by the American Geriatrics Society (AGS) in May.

NSAIDs should be “considered rarely, and with extreme caution, in highly selected individuals,” the new guideline states, contradicting the AGS's 2002 guideline. The new recommendation reflects evidence about serious cardiovascular and gastrointestinal tract risks associated with this class of drugs that has emerged since 2002, said Bruce Ferrell, MD, chair of the panel that created new guideline and professor of medicine and geriatrics at the University of California, Los Angeles. These drugs also may complicate the treatment of common conditions in this population, such as hypertension and congestive heart failure.