Abstract
Key summary pointsAimTo examine which client characteristics and other factors, including possible adverse effects, identified in the Resident Assessment Instrument-Home Care (RAI-HC) are associated with daily opioid use among aged home care clients.FindingsAfter adjustment for pain-related diseases, disabilities, depressive symptoms and the estimated severity of pain, daily opioid use was associated with osteoporosis, cancer within previous 5 years and greater disabilities in Instrumental Activities of Daily Living, and cognitive impairment was associated with less frequent opioid use. Constipation was the only adverse effect identified in the RAI-HC associated with daily opioid use.MessageThe pain of home care clients with cognitive impairment may not be treated optimally, whereas there might be prolonged opioid use without a sufficient evaluation of current pain among clients with osteoporosis, cancer within previous 5 years and disabilities in Instrumental Activities of Daily Living.
Highlights
Around one in ten home-dwelling older adults uses opioids, and the proportion is even greater when shorter periods of use are counted [1,2,3,4]
Cancer within previous 5 years, Parkinson’s disease, pressure ulcers, osteoporosis, arthritis and a history of fractures were more common among opioid users than non-users
Client characteristics associated with daily opioid use
Summary
Around one in ten home-dwelling older adults uses opioids, and the proportion is even greater when shorter periods of use are counted [1,2,3,4]. The most common indications for long-term opioid use among home care clients are musculoskeletal disorders, mainly vertebral osteoporotic fractures, degenerative spinal disorders and osteoarthritis [1]. As far as we know, factors associated with opioid use in home care clients with cognitive impairment have not been studied. The number needed to harm of opioid use is smaller among older adults (≥ 65 years) compared to younger persons [12], but the evidence for the adverse effects and events of long-term opioid use is insufficient. Long-term opioid users tolerate opioids, and their adverse effects may, differ from the populations in randomised controlled trials of short-term use
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