Prescribed opioid use is associated with increased all-purpose emergency department visits and hospitalizations in community-dwelling older adults in the United States

Song Ge; Chong Tian; Liang Wu; Minhui Liu; Haidong Lu

doi:10.3389/fpsyt.2022.1092199

Prescribed opioid use is associated with increased all-purpose emergency department visits and hospitalizations in community-dwelling older adults in the United States

Front Psychiatry. 2022 Dec 13:13:1092199. doi: 10.3389/fpsyt.2022.1092199. eCollection 2022.

Authors

Song Ge¹, Chong Tian², Liang Wu³, Minhui Liu⁴, Haidong Lu⁵

Affiliations

¹ RN-BSN Program, Department of Natural Sciences, University of Houston-Downtown, Houston, TX, United States.
² School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
³ Janssen R&D, San Diego, CA, United States.
⁴ Xiangya School of Nursing, Central South University, Changsha, China.
⁵ Department of Epidemiology of Microbial Diseases and the Public Health Modeling Unit, Yale School of Public Health, Yale University, New Haven, CT, United States.

Abstract

Background: The geriatric and health characteristics of older adults make them more susceptible to the effects of opioids than younger groups. The number of older adults in the United States visiting the emergency department (ED) and overusing opioids has increased in recent years. Research examining their relationship is, however, limited.

Methods: Using information from the 2020 National Health Interview Survey (NHIS), we included older adults aged 65 and older. To investigate the relationship between prescribed opioid use and 12-months ED visits and hospitalizations, linear regression and logistic regression models were built while adjusting for age, sex, ethnicity, education, employment, general health status, history of depression, and living arrangement.

Results: Our study population consisted of 8,631 participants (mean age 74.3). Most of them were females (58.3%) and Caucasian (81.6%). About 16% of the participants used prescribed opioids over the past 12 months. Of the participants with prescribed opioid use, 65.1% of them did so to treat chronic pain. The adjusted regression models revealed that prescribed opioid use was independently and positively associated with 12-months ED visits (β = 0.22, 95% confidence interval [CI] 0.18, 0.26) and hospitalizations (Odds ratio [OR] = 3.78, 95% CI 3.29, 4.35). Other risk factors for 12-months ED visits and/or hospitalizations included advanced age, male gender, unemployment/retirement, African American ethnicity, living alone, fair or poor general health status, and history of depression.

Discussions: Clinicians should screen older adults at high risk for ED visits and hospitalizations and explore multimodal pain management with them to help them reduce/stop using opioids. These efforts may decrease their chronic pain, opioid use, opioid use-related adverse health outcomes, ED visits, as well as hospitalizations.

Keywords: emergency department; hospitalization; national survey; older adults; opioid; pain.