Risk of chronic opioid use in older persons with pre-existing anxiety.
J Opioid Manag
; 16(1): 59-66, 2019.
Article
em En
| MEDLINE
| ID: mdl-32091618
ABSTRACT
OBJECTIVE:
Work that has shown a relationship between anxiety and chronic opioid use has not focused on older people specifically, despite the additional risks in older populations. This study aimed to understand whether anxiety prior to opioid initiation increased the likelihood of chronic opioid use over time in persons aged 60 years or older.DESIGN:
Administrative claims data were used to calculate time between initiation of opioids and a first chronic episode of opioid use. Patients were classified as having a history of anxiety if they were dispensed medicines in the anxiolytics class or had a hospitalization event for anxiety prior to treatment with an opioid. Proportional hazards models were used to compare the likelihood of experiencing a chronic episode of opioid use between those with and without a history of anxiety.RESULTS:
The cohort was 15,000 persons, of which, 5,076 (34 percent) had history of anxiety. Those with anxiety prior to their first opioid dispensing were 30 percent more likely to have an episode of chronic use after adjustment for age, gender, number of comorbidities, and prior surgery (HR = 1.30, 95% CI = 1.16-1.47). The risk of a chronic episode in patients who had surgery prior to initiation of an opioid was 60 percent greater in those with anxiety compared to no anxiety (HR = 1.60, 95% CI = 1.21-2.11) and 24 percent greater in those with anxiety but no prior surgery (HR = 1.24, 95% CI = 1.08-1.42).CONCLUSIONS:
A significant proportion of older people will have a chronic episode of opioid use. This risk is increased where a history of anxiety is present.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Ansiedade
/
Analgésicos Opioides
/
Transtornos Relacionados ao Uso de Opioides
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Humans
/
Middle aged
Idioma:
En
Revista:
J Opioid Manag
Assunto da revista:
NEUROLOGIA
/
PSICOFISIOLOGIA
/
TERAPIA POR MEDICAMENTOS
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Austrália