Doctor of Philosophy
Managing pain is a demanding task among elderly people as almost one third of them are experiencing chronic pain. Opioids are commonly prescribed to relieve pain symptoms, but there were no significant benefits compared with non-opioid medications. Guidelines from government agencies have dramatically changed the practice of opioid prescriptions in the community. However, for some legitimate reasons, many elderly people still need opioid medications to manage their pain. This research explored the trends of opioid use, chronic use, and heavy use of opioids among elderly people; examined the impact of different opioid use patterns on the healthcare utilizations among elderly patients with chronic non-cancer pain; and investigated the patterns and disparities of compound opioid medications for treating elderly patients with chronic non-cancer pain. These studies used Medicare Current Beneficiary (MCBS) data from 2006 to 2019 and included people aged 65 years and older who had part D prescription drug benefits. Of 119,964 participants included in the study, there was a decline of opioid use since 2015. However, the proportion of chronic use and heavy use of opioids remained stable. Of 13,751 participants who had any form of chronic non-cancer pain, chronic opioid users were 30% more likely to be hospitalized, and 50% more likely to have emergency department visits. Finally, chronic opioid users were 30-70% more likely to use high potency opioid medications (hydrocodone or oxycodone compounds) and 40% less likely to use codeine/butalbital compounds. Our findings suggest that a significant proportion of elderly patients were still at a higher risk of opioid misuse/abuse. Given higher prevalence of comorbidities and lower opioid metabolism among elderly people, risks of opioid complications, medication interactions, and medical emergencies should be actively monitored. Health care providers should be vigilant about these risks and educate patients about the proper use of pain medications including opioids.
Dissertation or thesis originally submitted to ProQuest
Bromley, Morgan Isaac, "The Shifting Paradigm of Pain Management Among U.S. Elderly Community Dwellers" (2023). Electronic Theses and Dissertations. 3072.