University of California San Francisco

Appropriate post-operative pain management for older adults

A core focus of Dr. Bongiovanni’s research program is pain management for older adults after surgery, with a particular focus on mutimodal pain regimens and prolonged use of pain medications. Her passion for this topic began with personal and clinical experiences, which showed her a one-size-fits-all approach leads to older adults being treated with inappropriate medications. Appropriate pain management is essential for older adults’ recovering from surgery, especially given the risks posed to older adults by these medications. Further, as surgeons increasingly use multimodal pain regimens in response to the opioid pandemic, use of many different drug classes complicates pain regimens and potential side effect profiles for older adults.
Dr. Bongiovanni’s research has documented prescribing patterns and unearthed concerning trends in pain management, especially prolonged use of pain medication occurring 90 or more days after surgery. She found that more than 10% of patients prescribed pain medications at hospital discharge went on to have prolonged use (use >90 days after surgery), a number that rises to 22% for patients with newly prescribed gabapentinoids after surgery and 38% for patients who discharge to a skilled nursing facility.

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