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Association of injury after prescription opioid initiation with risk for opioid-related adverse events among older
Yu-Jung Jenny Wei1,2,3, Cheng Chen4, Ting-Yuan David Cheng5
1Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, United States of America.
Plos Medicine
|September 22, 2022
Summary
Injury after starting prescription opioids increases the risk of opioid-related adverse events (ORAEs) in older adults. This risk is highest when the injury occurs within 30 days of the ORAE diagnosis.
Area of Science:
- Geriatric Medicine
- Pharmacology
- Public Health
Background:
- Prescription opioid use is common among older adults.
- Injury is a potential warning sign for opioid-related adverse events (ORAEs).
- The association between injury and ORAEs in this population has not been well-studied.
Purpose of the Study:
- To examine the association between incident injury after prescription opioid initiation and the subsequent risk of ORAEs.
- To assess if the association differs by the recency of injury.
Main Methods:
- Nested case-control study of 126,752 Medicare beneficiaries aged 65+.
- Included new opioid users with chronic non-cancer pain and no prior injury or ORAEs.
- Used multivariate conditional logistic regression to estimate ORAE risk associated with injury recency.
Main Results:
- 54% of ORAE cases and 46% of controls experienced incident injury post-opioid initiation.
- Injury after opioid initiation increased ORAE risk (aOR=1.4).
- Risk was significantly higher with current injury (≤30 days, aOR=2.8) but not with older injuries.
Conclusions:
- Incident injury following opioid initiation is linked to increased ORAE risk in older adults.
- The risk is significant only for injuries occurring within 30 days prior to the ORAE diagnosis.
- Monitoring for recent injuries may help identify high-risk older opioid users.
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