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Issue 32 Synovium (Spring 2011)
An interesting and important study in the Annals of Internal Medicine1 examined the experience of pain in the last 2 years of life in 4703 nationally representative patients (mean age [SD] 75.7 years) who died while enrolled in the Health and Retirement Study in the USA. The prevalence of pain was 26% at 2 years before death and remained at this level until beginning to rise at 4 months before death. In the last month of life 46% of patients had pain. The terminal diagnosis did not influence the likelihood of pain but the presence of arthritis did: 60% of patients with a diagnosis of arthritis experienced pain in the last month of life compared with 26% of patients without arthritis. This study suggests a significant unmet need and a further challenge in providing effective pain-relief without increasing risks.