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This is a Cross-Sectional Study study.

February 8, 2026BMC Public Health0 citationsOpen Access

Prevalence and associated factors of inappropriate analgesic drug use among community-dwelling older adults with chronic musculoskeletal pain: a cross-sectional study

NANatagarn AmpornpiriyakulPrince of Songkla University NKNarucha KomolsuradejPrince of Songkla University SSSiwaluk SrikrajangPrince of Songkla University

Key Points

This research aims to evaluate the prevalence and factors associated with inappropriate analgesic drug use among older adults with chronic musculoskeletal pain.
Conducted a cross-sectional study of 215 older adults aged ≥ 60 years with chronic musculoskeletal pain.
Participants were recruited through home visits in Hat Yai District, Thailand.
Analgesic use evaluated through direct inspection of medications used in the previous 3 months, cross-checked with Beers Criteria.
Patterns of inappropriate use categorized as potentially inappropriate medication use, overtreatment, and undertreatment.
Factors associated with inappropriate use analyzed using multivariate logistic regression analysis.
Inappropriate analgesic drug use was prevalent in 66.5% of participants.
Potentially inappropriate medication use was at 71.3%, overtreatment at 24.5%, and undertreatment at 33.6%.
Non-prescribed polypharmaceutical packs were linked to higher risk with an aOR of 11.45 (P < 0.001).
Pain interference with enjoyment of life also associated with increased risk (aOR = 1.16, P = 0.007).

Abstract

Musculoskeletal disorders are frequently associated with pain in older adults, and the use of inappropriate analgesics drugs is common. Understanding the patterns and factors of inappropriate analgesic use may help reduce its prevalence among older adults with chronic musculoskeletal pain. This cross-sectional study evaluated 215 older adults aged ≥ 60 years who experienced chronic musculoskeletal pain and used oral medication to relieve pain within the previous 3 months. Participants were recruited through home visits using the community health register in Ban Phru, Hat Yai District, Songkhla Province (Southern Thailand) between July and December 2023. Analgesic use was determined by directly inspecting the drugs that participants were taking within the previous 3 months, regardless of whether they were prescribed or self-purchased. The name, dose, and source of each medication were recorded and cross-checked with the 2023 American Geriatrics Society Beers Criteria to identify potentially inappropriate drugs. This approach enabled differentiation into three patterns of inappropriate analgesic drug use: potentially inappropriate medication use, overtreatment, and undertreatment. Factors associated with the inappropriate use of analgesic drugs were analysed using multivariate logistic regression analysis. Inappropriate analgesic drug use was prevalent in 66. 5%. Regarding the prevalence rates by pattern, potentially inappropriate, overtreatment, and undertreatment were prevalent in 71. 3%, 24. 5%, and 33. 6%, respectively. Non-prescribed polypharmaceutical packs (adjusted odds ratio aOR 95% confidence interval CI = 11. 45 3. 32, 72. 15, P < 0. 001) and pain interfering with enjoyment of life (aOR 95% CI = 1. 16 1. 04, 1. 30, P = 0. 007) were significantly associated with inappropriate analgesic drug use. Inappropriate analgesic use was common, affecting 66. 5% of community-dwelling older adults with chronic musculoskeletal pain. Non-prescribed polypharmaceutical packs and pain interference were significant predictors of inappropriate use. These findings underscore the influence of inappropriate self-medication, suggesting the need for greater attention from healthcare providers to promote safe and rational analgesic use in this population.

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