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Synovium front cover

Issue 32 (Spring 2011)

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In the last issue of Synovium we asked the question ‘Should healthy older people with joint pain consult their doctor?’, and reported on a study examining the perceptions of a small group of older people about the normality, or otherwise, of joint pain in later years. Here is another similar but perhaps more profound question: ‘Is it better for older people to accept joint pain as a normal part of the ageing process and manage their joint pain as best they can or would they have better outcomes as a result of consulting their GP?’ The answer to this question clearly depends on what people might do themselves to manage their own joint pain and what their GPs might do. Many patients – perhaps most – receive prescriptions from their GPs for medication to help manage their joint pain. We have previously reported on the potential hazards of non-steroidal anti-inflammatory drugs (NSAIDs) in older patients. In the third item in this issue it is the turn of opioid medications to come under the spotlight of the systematic reviewers.

Adrian Dunbar, Medical Editor

Joint pain at the end of life

An interesting and important study in the Annals of Internal Medicine examined the experience of pain in the last 2 years of life in 4703 nationally representative patients who died while enrolled in the Health and Retirement Study in the USA.

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The benefits and risks of treating joint pain in older people with opioid medications

A systematic review published in the Journal of the American Geriatrics Society looked at evidence with respect to the ‘efficacy, safety, and abuse and misuse potential’ of opioid drugs in older people (>60 years) with non-cancer pain.

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In praise of... 10-minute consultation

It becomes increasingly challenging to do all that is necessary, patient-centred, evidence-based and health-promoting and to maximise the QoF points within the 10 minutes of consultation time traditionally allocated in primary care.

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