Australian aged care residents seven times more likely to be taking painkiller medications when compared with Japan

A new study from Monash University, in collaboration with Japan’s Institute for Health Economics and Policy, has revealed that only 11 per cent of Japanese aged care facility residents are prescribed regular painkiller medications, compared to nearly three-quarters (74 per cent) of Australia’s aged care facility population.  

Furthermore, the use of opioid painkiller medicines in aged care facilities was found to be 30-fold higher in Australia.

The study, published in the medical journal Age and Ageing and led by Monash’s Centre for Medicine Use and Safety (CMUS) within the Monash Institute of Pharmaceutical Sciences (MIPS), compared painkiller use among two samples of Australian and Japanese residents with the goal to better understand the pharmacological management of pain in residential aged care.

The painkiller medicines in most regular use include oral acetaminophen (paracetamol), non-steroidal anti-inflammatory drugs (e.g. ibuprofen), or opioids.

Qualitative data obtained through focus groups with Australian and Japanese health care professionals highlighted the differences in therapeutic goals, painkiller regulations and treatment durations between the two countries.

The study’s lead author Ms Laura Dowd, a pharmacist and CMUS PhD candidate, said these differences may explain the disparities in painkiller use between the respective countries.

“Australian participants described their therapeutic goal was to alleviate pain and reported painkillers were often prescribed on a regular basis, whilst Japanese participants described their therapeutic goal was to minimise impacts of pain on daily activities and reported opioid painkillers were prescribed for short-term durations, corresponding to episodes of pain,” Ms Dowd said.

“Australia and Japan both have rapidly ageing populations but appear to have very different patterns of painkiller use. Understanding these differences can inform new initiatives to improve pain management.”

Senior author and CMUS Research Fellow Dr Amanda Cross said, “This study confirms previous CMUS research that shows up to one-third of Australian residents are prescribed opioid painkiller medicines and highlights key areas where on-site aged care pharmacists could work to support the appropriate use of opioids.”

Dr Shota Hamada from the Institute for Health Economics and Policy in Tokyo said, “Painkillers are one component of an effective pain management strategy. Understanding the different role of painkillers as part of the overall approach to pain management will help the safe and effective painkiller use.”

To read the full study visit https://academic.oup.com/ageing/article/53/2/afae024/7614404.