Patterns of pain medication usage and self-reported pain in older Irish adults with osteoarthritis: A latent class analysis of data from the Irish Longitudinal Study on Ageing

BMC Musculoskelet Disord. 2024 Oct 2;25(1):773. doi: 10.1186/s12891-024-07854-8.

Abstract

Background: This study aimed to identify and describe links between pain medication use and self-reported pain among people aged ≥ 50 years with osteoarthritis (OA) in an Irish population, and to examine the relationships between pain, medication usage and socioeconomic and clinical characteristics.

Methods: Secondary data analysis of wave 1 cross-sectional data from The Irish Longitudinal Study on Ageing (TILDA) was undertaken of 1042 people with self-reported doctor-diagnosed OA. We examined use of medications typically included in OA clinical guidelines, including non-opioid analgesics (e.g. paracetamol), topical and oral non-steroidal anti-inflammatory drugs (NSAIDs), opioids and nutraceuticals. Latent Class Analysis (LCA) was used to identify underlying clinical subgroups based on medication usage patterns, and self-reported pain severity. Multinomial logistic regression was used to explore sociodemographic and clinical characteristic links to latent class membership.

Results: A total of 358 (34.4%) of the 1042 people in this analysis were taking pain medications including oral NSAIDs (17.5%), analgesics (11.4%) and opioids (8.7%). Nutraceutical (glucosamine/chondroitin) use was reported by 8.6% and topical NSAID use reported by 1.4%. Three latent classes were identified: (1) Low medication use/no pain (n = 382, 37%), (2) low medication use/moderate pain (n = 523, 50%) and (3) moderate medication use/high pain (n = 137, 13%). Poorer self-rated health and greater sleep disturbance were associated with classes 2 and 3; depressive symptoms and female gender were associated with class 2, and retirement associated with class 3.

Conclusions: Whilst pain medication use varied with pain severity, different medication types reported broadly aligned with OA guidelines. The two subgroups exhibiting higher pain levels demonstrated poorer self-rated health and greater sleep disturbance.

Keywords: Clinical guidelines; Latent class analysis; Medications; Osteoarthritis; Pain.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analgesics / therapeutic use
  • Analgesics, Opioid / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Cross-Sectional Studies
  • Female
  • Humans
  • Ireland / epidemiology
  • Latent Class Analysis*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Osteoarthritis* / diagnosis
  • Osteoarthritis* / drug therapy
  • Osteoarthritis* / epidemiology
  • Pain / drug therapy
  • Pain / epidemiology
  • Pain Measurement
  • Self Report*

Substances

  • Analgesics
  • Anti-Inflammatory Agents, Non-Steroidal
  • Analgesics, Opioid