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dc.contributor.authorHunnicutt, Jacob N.
dc.contributor.authorChrysanthopoulou, Stavroula A.
dc.contributor.authorUlbricht, Christine M.
dc.contributor.authorHume, Anne L.
dc.contributor.authorTjia, Jennifer
dc.contributor.authorLapane, Kate L.
dc.date2022-08-11T08:08:22.000
dc.date.accessioned2022-08-23T15:52:36Z
dc.date.available2022-08-23T15:52:36Z
dc.date.issued2017-09-21
dc.date.submitted2017-12-06
dc.identifier.citation<p>J Am Geriatr Soc. 2017 Sep 21. doi: 10.1111/jgs.15080. [Epub ahead of print] <a href="https://doi.org/10.1111/jgs.15080">Link to article on publisher's site</a></p>
dc.identifier.issn0002-8614 (Linking)
dc.identifier.doi10.1111/jgs.15080
dc.identifier.pmid28940193
dc.identifier.urihttp://hdl.handle.net/20.500.14038/29175
dc.description.abstractBACKGROUND/OBJECTIVES: Overall and long-term opioid use among older adults have increased since 1999. Less is known about opioid use in older adults in nursing homes (NHs). DESIGN: Cross-sectional. SETTING: U.S. NHs (N = 13,522). PARTICIPANTS: Long-stay NH resident Medicare beneficiaries with a Minimum Data Set 3.0 (MDS) assessment between April 1, 2012, and June 30, 2012, and 120 days of follow-up (N = 315,949). MEASUREMENTS: We used Medicare Part D claims to measure length of opioid use in the 120 days from the index assessment (short-term: < /=30 days, medium-term: > 30-89 days, long-term: > /=90 days), adjuvants (e.g., anticonvulsants), and other pain medications (e.g., corticosteroids). MDS assessments in the follow-up period were used to measure nonpharmacological pain management use. Modified Poisson models were used to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) for age, gender, race and ethnicity, cognitive and physical impairment, and long-term opioid use. RESULTS: Of all long-stay residents, 32.4% were prescribed any opioid, and 15.5% were prescribed opioids long-term. Opioid users (versus nonusers) were more commonly prescribed pain adjuvants (32.9% vs 14.9%), other pain medications (25.5% vs 11.0%), and nonpharmacological pain management (24.5% vs 9.3%). Long-term opioid use was higher in women (aPR = 1.21, 95% CI = 1.18-1.23) and lower in racial and ethnic minorities (non-Hispanic blacks vs whites: APR = 0.93, 95% CI = 0.90-0.94) and those with severe cognitive impairment (vs no or mild impairment, aPR = 0.82, 95% CI = 0.79-0.83). CONCLUSION: One in seven NH residents was prescribed opioids long-term. Recent guidelines on opioid prescribing for pain recommend reducing long-term opioid use, but this is challenging in NHs because residents may not benefit from nonpharmacological and nonopioid interventions. Studies to address concerns about opioid safety and effectiveness (e.g., on pain and functional status) in NHs are needed.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=28940193&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://doi.org/10.1111/jgs.15080
dc.subjectUMCCTS funding
dc.subjectnursing homes
dc.subjectopioids
dc.subjectpain adjuvants
dc.subjectpain management
dc.subjectChemical Actions and Uses
dc.subjectGeriatrics
dc.subjectMusculoskeletal, Neural, and Ocular Physiology
dc.subjectPathological Conditions, Signs and Symptoms
dc.subjectPsychological Phenomena and Processes
dc.subjectTherapeutics
dc.titlePrevalence of Long-Term Opioid Use in Long-Stay Nursing Home Residents
dc.typeJournal Article
dc.source.journaltitleJournal of the American Geriatrics Society
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/faculty_pubs/1400
dc.identifier.contextkey11207530
html.description.abstract<p>BACKGROUND/OBJECTIVES: Overall and long-term opioid use among older adults have increased since 1999. Less is known about opioid use in older adults in nursing homes (NHs).</p> <p>DESIGN: Cross-sectional.</p> <p>SETTING: U.S. NHs (N = 13,522).</p> <p>PARTICIPANTS: Long-stay NH resident Medicare beneficiaries with a Minimum Data Set 3.0 (MDS) assessment between April 1, 2012, and June 30, 2012, and 120 days of follow-up (N = 315,949).</p> <p>MEASUREMENTS: We used Medicare Part D claims to measure length of opioid use in the 120 days from the index assessment (short-term: < /=30 days, medium-term: > 30-89 days, long-term: > /=90 days), adjuvants (e.g., anticonvulsants), and other pain medications (e.g., corticosteroids). MDS assessments in the follow-up period were used to measure nonpharmacological pain management use. Modified Poisson models were used to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) for age, gender, race and ethnicity, cognitive and physical impairment, and long-term opioid use.</p> <p>RESULTS: Of all long-stay residents, 32.4% were prescribed any opioid, and 15.5% were prescribed opioids long-term. Opioid users (versus nonusers) were more commonly prescribed pain adjuvants (32.9% vs 14.9%), other pain medications (25.5% vs 11.0%), and nonpharmacological pain management (24.5% vs 9.3%). Long-term opioid use was higher in women (aPR = 1.21, 95% CI = 1.18-1.23) and lower in racial and ethnic minorities (non-Hispanic blacks vs whites: APR = 0.93, 95% CI = 0.90-0.94) and those with severe cognitive impairment (vs no or mild impairment, aPR = 0.82, 95% CI = 0.79-0.83).</p> <p>CONCLUSION: One in seven NH residents was prescribed opioids long-term. Recent guidelines on opioid prescribing for pain recommend reducing long-term opioid use, but this is challenging in NHs because residents may not benefit from nonpharmacological and nonopioid interventions. Studies to address concerns about opioid safety and effectiveness (e.g., on pain and functional status) in NHs are needed.</p>
dc.identifier.submissionpathfaculty_pubs/1400
dc.contributor.departmentDepartment of Quantitative Health Sciences


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