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Potentially inappropriate opioid use in older adults significantly increases mortality risk. This study highlights the need for safer pain management strategies to protect this vulnerable population.

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Area of Science:

  • Gerontology
  • Pharmacology
  • Public Health

Background:

  • Aging populations necessitate understanding medication risks.
  • Potentially inappropriate medication (PIM) use is a growing concern in older adults.
  • Limited research exists on PIM involving opioids and mortality in community-dwelling older adults.

Purpose of the Study:

  • To investigate the association between PIM involving opioids and all-cause mortality.
  • To assess the risk of death in community-dwelling older adults exposed to PIM opioids.

Main Methods:

  • A nested case-control study within a longitudinal cohort of adults aged ≥65 years.
  • Matched 40 cases (deaths) to 160 controls using risk-set sampling.
  • Assessed PIM involving opioids using Beers 2019 criteria from drug claims data within 90 days before death.

Main Results:

  • An incident episode of opioid use was observed in 472 older adults.
  • Exposure to PIM involving opioids within 90 days of death was linked to a 6.81-fold increased mortality risk (OR 6.81, 95% CI 1.69-27.47).
  • This association remained significant after adjusting for confounders.

Conclusions:

  • PIM involving opioids is associated with increased mortality in older adults.
  • Findings underscore the importance of optimizing pain management in the elderly.
  • Safer prescribing practices for opioids in older adults are recommended.