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dc.contributor.authorHunnicutt, Jacob N.
dc.contributor.authorUlbricht, Christine M.
dc.contributor.authorHume, Anne
dc.contributor.authorLapane, Kate L.
dc.date2022-08-11T08:08:16.000
dc.date.accessioned2022-08-23T15:48:20Z
dc.date.available2022-08-23T15:48:20Z
dc.date.issued2017-05-16
dc.date.submitted2017-06-26
dc.identifier.doi10.13028/maff-yb64
dc.identifier.urihttp://hdl.handle.net/20.500.14038/28190
dc.description.abstractBackground: There is limited information on the prevalence and multilevel risk factors of long-term opioid use in older nursing home residents despite their high burden of pain and vulnerability to adverse drug events. Objectives: To estimate the prevalence and correlates of long-term opioid use in United States (US) nursing homes. Methods: We used comprehensive administrative/claims data (Minimum Data Set 3.0; Medicare Part D) from 2012 to conduct a cross-sectional study of 369,180 long-stay nursing home residents who were Medicare beneficiaries, ≥65 years old, and had no cancer. Resident factors of interest included demographics and physical/cognitive impairment, and facility factors included US census region and structural characteristics (eg, bed size, ownership). Long-term opioid use was defined as ≥90 cumulative days of opioid use during a 120 day observation window - defined using fill dates and days’. Modified Poisson models were used to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) between resident/ facility-level characteristics and long-term opioid use. Results: Nearly one third of long-stay residents used any opioid, with 14.5% using opioids long-term. Among long-term users, 35.3% received a long-acting opioid, with 17.1% receiving high (≥90 mg/day oral morphine equivalents) daily doses. Hydrocodone (49.0%), tramadol (31.3%), and fentanyl (24.8%) were most commonly used. The prevalence of long-term use was higher in women (vs. men; aPR=1.20, 95% CI: 1.18-1.23) and those with no/mild cognitive impairment (vs. other; aPR=1.18, 95% CI: 1.16-1.20) or severe physical impairment (aPR=1.25; 95% CI: (1.22-1.27), and in government-owned nursing homes (vs. for-profit; aPR=1.10, 95% CI: 1.05-1.16). Long-term use varied by region (10.6% [Northeast] to 17.7% [Midwest]) and across facilities (median: 13.3% interquartile range: 6.7%-21.3%). Conclusions: Long-term opioid use is substantially higher in nursing home residents than what has been previously reported in community-dwelling older adults. Further investigations of opioid safety in this frail population are needed.
dc.formatflash_audio
dc.language.isoen_US
dc.rightsCopyright the Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/3.0/
dc.subjectnursing homes
dc.subjectopioid use
dc.subjectadverse drug effects
dc.subjectGeriatrics
dc.subjectHealth Services Administration
dc.subjectPharmacy and Pharmaceutical Sciences
dc.subjectTranslational Medical Research
dc.titleResident and Facility-level Correlations of Long-term Opioid Use in United States Nursing Homes
dc.typePoster Abstract
dc.identifier.legacyfulltexthttps://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1514&context=cts_retreat&unstamped=1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/cts_retreat/2017/posters/39
dc.identifier.contextkey10353397
refterms.dateFOA2022-08-23T15:48:20Z
html.description.abstract<p><strong>Background:</strong> There is limited information on the prevalence and multilevel risk factors of long-term opioid use in older nursing home residents despite their high burden of pain and vulnerability to adverse drug events.</p> <p><strong>Objectives:</strong> To estimate the prevalence and correlates of long-term opioid use in United States (US) nursing homes.</p> <p><strong>Methods:</strong> We used comprehensive administrative/claims data (Minimum Data Set 3.0; Medicare Part D) from 2012 to conduct a cross-sectional study of 369,180 long-stay nursing home residents who were Medicare beneficiaries, ≥65 years old, and had no cancer. Resident factors of interest included demographics and physical/cognitive impairment, and facility factors included US census region and structural characteristics (eg, bed size, ownership). Long-term opioid use was defined as ≥90 cumulative days of opioid use during a 120 day observation window - defined using fill dates and days’. Modified Poisson models were used to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) between resident/ facility-level characteristics and long-term opioid use.</p> <p><strong>Results: </strong>Nearly one third of long-stay residents used any opioid, with 14.5% using opioids long-term. Among long-term users, 35.3% received a long-acting opioid, with 17.1% receiving high (≥90 mg/day oral morphine equivalents) daily doses. Hydrocodone (49.0%), tramadol (31.3%), and fentanyl (24.8%) were most commonly used. The prevalence of long-term use was higher in women (vs. men; aPR=1.20, 95% CI: 1.18-1.23) and those with no/mild cognitive impairment (vs. other; aPR=1.18, 95% CI: 1.16-1.20) or severe physical impairment (aPR=1.25; 95% CI: (1.22-1.27), and in government-owned nursing homes (vs. for-profit; aPR=1.10, 95% CI: 1.05-1.16). Long-term use varied by region (10.6% [Northeast] to 17.7% [Midwest]) and across facilities (median: 13.3% interquartile range: 6.7%-21.3%).</p> <p><strong>Conclusions:</strong> Long-term opioid use is substantially higher in nursing home residents than what has been previously reported in community-dwelling older adults. Further investigations of opioid safety in this frail population are needed.</p>
dc.identifier.submissionpathcts_retreat/2017/posters/39


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