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Patient Characteristics and Risk of Fall-Related Injuries Among New Users of Opioids in Denmark: A Longitudinal
Juliane Maria Rosendahl1,2, Carina Lundby1,2, Jacob Harbo Andersen2
1Hospital Pharmacy Funen, Odense University Hospital, Odense C, Denmark.
Pharmacoepidemiology and Drug Safety
|August 12, 2026
Summary
New opioid users face an 8.6% risk of fall injuries within a year, with the highest risk occurring shortly after starting medication. Key risk factors include age, depression, and previous falls.
Area of Science:
- Gerontology
- Pharmacology
- Public Health
Background:
- Opioid analgesics are widely prescribed for pain management.
- Falls and subsequent injuries pose a significant health risk, particularly in older adults.
- Understanding fall risk associated with new opioid initiation is crucial for patient safety.
Purpose of the Study:
- To determine the 1-year incidence of fall-related injuries among new adult users of opioids in Denmark.
- To identify specific risk factors associated with fall-related injuries and fractures in this population.
Main Methods:
- Utilized Danish health registers to identify new adult opioid users from 2010-2022.
- Employed logistic regression and marginal comparisons to assess risk ratios for fall-related injuries and fractures.
- Followed patients for 1 year post-initiation or until a fall-related injury, death, or emigration.
Main Results:
- Identified 1,638,358 new opioid users (54% female, median age 58).
- The 1-year risk of fall-related injuries was 8.6%, and fall-related fractures was 3.6%.
- Risk was highest in the initial weeks of opioid use; age, depression, Parkinson's, osteoporosis, and prior falls were significant predictors.
Conclusions:
- New opioid users have a substantial risk of fall-related injuries and fractures within the first year, peaking early in treatment.
- Identifying patients with pre-existing conditions and a history of falls is vital for mitigating risk.
- Clinicians should consider patient-specific fall risk factors when prescribing opioids.
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