Incidence of Opioid Dose Tapering Among Older Adults Enrolled in Medicare
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View abstract on PubMed
Summary
This summary is machine-generated.Nearly half of older adults on long-term opioid therapy tapered within a year, with factors like multiple pain conditions and the 2016 CDC guideline influencing tapering rates. Understanding these opioid tapering patterns is key for safer pain management.
Area Of Science
- Gerontology
- Pharmacology
- Epidemiology
Background
- Long-term opioid therapy (LTOT) is common for chronic noncancer pain.
- Opioid risks necessitate evaluation of tapering and discontinuation strategies.
- Opioid tapering is complex due to withdrawal and adverse outcomes, especially in older adults.
Purpose Of The Study
- To determine the incidence rate of opioid tapering among older adults on LTOT.
- To identify factors associated with any tapering and rapid opioid tapering.
- To inform strategies for optimizing pain management safety in older populations.
Main Methods
- Cohort study using a 5% national sample of Medicare administrative claims (2012-2019).
- Included individuals aged 65+ on LTOT.
- Analyzed time to tapering, predictor variables, and used survival curves and Cox models.
Main Results
- 146,605 Medicare beneficiaries on LTOT were included.
- Nearly 50% experienced any tapering and 25% rapid tapering within the first year.
- Multiple pain conditions, hepatic impairment, sleep disorders, higher opioid dose, and post-2016 LTOT initiation increased tapering rates.
- The 2016 CDC guideline release correlated with increased hazards for any (45%) and rapid (64%) tapering.
Conclusions
- Opioid tapering is common among older adults on LTOT.
- Specific clinical and demographic factors predict tapering.
- The 2016 CDC guideline significantly influenced opioid tapering rates, highlighting its impact on clinical practice.
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