Chronic pain with use of analgesics and mortality in the home healthcare elderly: a nationwide population-based study

Background Chronic pain may cause increased complications and all-cause mortality. However, nationwide data on elderly patients receiving home healthcare (HHC) remain unknown. Therefore, we conducted this study to address this issue. Methods We identified elderly individuals (≥ 65 years) with chronic pain receiving HCC between 2002 and 2013 in the Taiwan National Health Insurance Research Database. The comparisons of the causes of chronic pain, comorbidities, follow-up mortality, and the use of analgesics between two sexes and among three age subgroups were performed. Results A total of 1435 participants were identified, with a mean age of 77.8 ± 7.1 years and male percentage of 46.7%. The prevalence of chronic pain was 5.8%. Chronic pain was most prevalent in the 75–84 years age group (46.5%). Malignancy was the most common cause of chronic pain (94.2%), followed by peripheral vascular diseases (6.0%), osteoarthritis (4.3%), pressure ulcer (3.9%), spine diseases (3.1%), osteoporosis (1.3%), and headache (1.3%). The follow-up mortality was 32.8% within 6 month, 64.1% within 1 year, 79.9% within 2 years, and 84.3% within 3 years without difference in two sexes and age subgroups. Acetaminophen was found to be the most common analgesics, followed by non-steroidal anti-inflammatory drugs and opioids. Morphine was the most commonly used opioid. Conclusions This study delineates the causes of chronic pain, use of analgesics, and follow-up mortality in the HHC elderly, clarifying the relationship between chronic pain and the HCC elderly. This will facilitate the further investigation of this issue in the future.