Analgesic and adjuvant co-prescribing in Australian and Finnish residential care homes

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dc.contributor.authorDowd, L.A.
dc.contributor.authorPitkälä, K.H.
dc.contributor.authorJadczak, A.D.
dc.contributor.authorRoitto, H.-M.
dc.contributor.authorAalto, U.L.
dc.contributor.authorSaarela, R.K.T.
dc.contributor.authorVisvanathan, R.
dc.contributor.authorLiau, S.J.
dc.contributor.authorCross, A.J.
dc.contributor.authorBell, J.S.
dc.date.issued2025
dc.description.abstractOBJECTIVE: To explore the co-prescribing of analgesic and/or adjuvant medications among residents of Australian and Finnish residential care homes. METHOD: Secondary cross-sectional analyses of prescribing data from residents of 12 Australian residential care homes in 2019 and 53 Finnish nursing homes and assisted living facilities in 2017-2018. Demographic characteristics and medication data were extracted from medical records and medication administration charts. Co-prescribing was defined as more than one analgesic (acetaminophen, non-steroidal anti-inflammatory drugs and opioids) and/or adjuvant (gabapentinoids, tricyclic antidepressants and duloxetine) medication prescribed for regular administration. RESULTS: Overall, 550 Australian residents (89 [IQR 84-92] years; 73% females) and 2423 Finnish residents (84 [IQR 65-103] years; 74% females) were included. Of 416 Australian residents prescribed any regular analgesic or adjuvant, 181 (44%) were prescribed two or more, including 66 (16%) who were prescribed three or more. Of 1406 Finnish residents prescribed any regular analgesic or adjuvant, 469 (33%) were prescribed two or more, including 87 (6%) who were prescribed three or more. Acetaminophen was co-prescribed to more than 75% of Australian and 43% of Finnish residents prescribed other analgesics or adjuvants. Of 61 Australian residents and 186 Finnish residents prescribed gabapentinoids, 38 (62%) and 86 (46%) were co-prescribed opioids. Opioids were co-prescribed to 59%-83% of Australian and 25%-46% of Finnish residents prescribed adjuvants. CONCLUSIONS: Analgesic and adjuvant co-prescribing was more prevalent for Australian than Finnish residents, which was largely driven by acetaminophen co-prescribing to more than three quarters of analgesic or adjuvant users in Australia. Central nervous system-active polypharmacy arising from high rates of adjuvant and opioid co-prescribing warrants further attention.
dc.description.statementofresponsibilityLaura A. Dowd, Kaisu H. Pitkälä, Agathe D. Jadczak, Hanna-Maria Roitto, Ulla L. Aalto, Riitta K.T. Saarela, Renuka Visvanathan, Shin J. Liau, Amanda J. Cross, J. Simon Bell
dc.identifier.citationAustralasian Journal on Ageing, 2025; 44(3):e70062-1-e70062-11
dc.identifier.doi10.1111/ajag.70062
dc.identifier.issn1440-6381
dc.identifier.issn1741-6612
dc.identifier.orcidJadczak, A.D. [0000-0002-7501-7996]
dc.identifier.orcidVisvanathan, R. [0000-0002-1303-9479]
dc.identifier.urihttps://hdl.handle.net/2440/148063
dc.language.isoen
dc.publisherWiley
dc.relation.grantNHMRC
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/2009633
dc.rights© 2025 The Author(s). Australasian Journal on Ageing published by John Wiley & Sons Australia, Ltd on behalf of AJA Inc. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
dc.source.urihttps://doi.org/10.1111/ajag.70062
dc.subjectanalgesics; nursing Homes; pain Management; polypharmacy
dc.subject.meshHumans
dc.subject.meshAnalgesics
dc.subject.meshPolypharmacy
dc.subject.meshCross-Sectional Studies
dc.subject.meshAged
dc.subject.meshAged, 80 and over
dc.subject.meshHomes for the Aged
dc.subject.meshNursing Homes
dc.subject.meshAustralia
dc.subject.meshFinland
dc.subject.meshFemale
dc.subject.meshMale
dc.subject.meshPractice Patterns, Physicians'
dc.titleAnalgesic and adjuvant co-prescribing in Australian and Finnish residential care homes
dc.typeJournal article
pubs.publication-statusPublished

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