From: Quality of opioid prescribing in older adults with or without Alzheimer disease and related dementia
Baseline characteristica | Patients with chronic pain, % | Opioid-naive patients, % | Patients with neuropathic pain, % | Patients with opioid prescription, % | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
With ADRD | Without ADRD | P-valued | With ADRD | Without ADRD | P-valued | With ADRD | Without ADRD | P-valued | With ADRD | Without ADRD | P-valued | |
Total no. | 75,258 | 435,870 | 48,182 | 304,009 | 9775 | 64,692 | 27,801 | 197,886 | ||||
Age, y | ||||||||||||
Mean (SD) | 79.3 (10.4) | 70.9 (9.4) | < .001 | 80.4 (10.1) | 72.1 (8.8) | < .001 | 76.5 (10.1) | 69.7 (9.3) | < .001 | 77.8 (10.6) | 69.2 (9.8) | < .001 |
50–64 | 9.4 | 19.3 | 7.5 | 13.1 | 12.5 | 23.2 | 11.9 | 27.2 | ||||
65–74 | 19.3 | 48.0 | 17.1 | 50.9 | 26.2 | 48.0 | 22.5 | 44.6 | ||||
75–84 | 36.3 | 24.7 | 36.4 | 27.0 | 38.1 | 22.6 | 36.1 | 21.7 | ||||
≥ 85 | 35.0 | 8.0 | 38.9 | 8.9 | 23.1 | 6.1 | 29.5 | 6.5 | ||||
Female | 71.1 | 63.1 | < .001 | 69.5 | 62.4 | < .001 | 67.3 | 62.0 | < .001 | 73.5 | 64.0 | < .001 |
Race/ethnicity | ||||||||||||
White | 78.7 | 82.0 | < .001 | 78.0 | 82.6 | < .001 | 76.8 | 82.1 | < .001 | 79.4 | 81.2 | < .001 |
Black | 11.7 | 10.4 | 11.3 | 9.1 | 12.4 | 10.3 | 12.3 | 12.3 | ||||
Othersb | 9.6 | 7.6 | 10.6 | 8.3 | 10.8 | 7.6 | 8.2 | 6.4 | ||||
US region | ||||||||||||
Northeast | 21.0 | 18.9 | < .001 | 24.7 | 20.9 | < .001 | 20.7 | 19.6 | < .001 | 15.1 | 15.0 | < .001 |
Midwest | 21.7 | 24.5 | 21.5 | 24.7 | 19.9 | 23.9 | 22.0 | 24.3 | ||||
South | 40.1 | 38.4 | 36.8 | 36.1 | 42.3 | 39.0 | 45.6 | 42.8 | ||||
West or other regions | 17.2 | 18.2 | 17.1 | 18.3 | 17.1 | 17.5 | 17.2 | 17.8 | ||||
Low-income subsidy | 44.0 | 34.5 | < .001 | 41.2 | 28.5 | < .001 | 46.6 | 35.7 | < .001 | 47.9 | 42.3 | < .001 |
Tobacco or alcohol use | 6.7 | 6.5 | .057 | 4.6 | 4.1 | < .001 | 7.3 | 6.7 | .021 | 9.3 | 9.5 | .391 |
Drug use disorder | 2.3 | 1.6 | < .001 | 1.1 | 0.6 | < .001 | 3.0 | 1.8 | < .001 | 3.9 | 2.7 | < .001 |
Index pain diagnosisc | ||||||||||||
Musculoskeletal | 88.8 | 86.7 | < .001 | 89.4 | 87.4 | < .001 | 24.5 | 19.7 | < .001 | 88.0 | 86.3 | < .001 |
Neuropathic | 13.0 | 14.8 | < .001 | 12.2 | 14.3 | < .001 | 100.0 | 100.0 | NA | 14.2 | 15.2 | < .001 |
Idiopathic | 2.4 | 2.0 | < .001 | 1.2 | 0.8 | < .001 | 1.2 | 0.7 | < .001 | 4.1 | 3.6 | < .001 |
Comorbidity affecting pain treatment | ||||||||||||
Cardiovascular disease | 85.4 | 68.1 | < .001 | 83.3 | 65.0 | < .001 | 86.8 | 70.3 | < .001 | 87.5 | 71.2 | < .001 |
Pulmonary condition | 52.9 | 40.7 | < .001 | 47.9 | 35.9 | < .001 | 53.5 | 41.0 | < .001 | 59.2 | 46.5 | < .001 |
Diabetes | 39.8 | 34.3 | < .001 | 38.0 | 32.4 | < .001 | 59.4 | 47.7 | < .001 | 42.6 | 36.7 | < .001 |
Mental disorder | 37.9 | 17.6 | < .001 | 32.9 | 13.2 | < .001 | 37.5 | 18.8 | < .001 | 43.5 | 22.7 | < .001 |
Gastrointestinal tract disorder | 27.2 | 13.7 | < .001 | 23.8 | 11.4 | < .001 | 26.8 | 14.2 | < .001 | 30.6 | 15.9 | < .001 |
Urinary tract infection | 24.6 | 9.4 | < .001 | 22.1 | 8.1 | < .001 | 22.3 | 10.0 | < .001 | 26.9 | 10.7 | < .001 |
Kidney disease | 21.8 | 11.2 | < .001 | 19.3 | 9.6 | < .001 | 24.3 | 13.1 | < .001 | 24.7 | 13.0 | < .001 |
Fall or fracture | 19.5 | 5.5 | < .001 | 14.7 | 3.2 | < .001 | 13.8 | 4.5 | < .001 | 22.7 | 7.0 | < .001 |
Neurodegenerative disease | 13.7 | 3.5 | < .001 | 12.6 | 2.7 | < .001 | 15.9 | 4.7 | < .001 | 15.0 | 4.3 | < .001 |
Liver disease | 6.1 | 4.3 | < .001 | 5.2 | 3.5 | < .001 | 6.6 | 4.6 | < .001 | 6.9 | 5.1 | < .001 |
Health care utilization | ||||||||||||
Any hospitalization stay | 25.0 | 8.2 | < .001 | 20.5 | 5.1 | < .001 | 21.4 | 7.9 | < .001 | 28.7 | 10.6 | < .001 |
Any ED visit | 28.3 | 14.0 | < .001 | 21.9 | 9.2 | < .001 | 26.9 | 14.3 | < .001 | 33.5 | 18.1 | < .001 |
Any hospital surgical procedure | 6.9 | 3.3 | < .001 | 4.4 | 1.3 | < .001 | 5.3 | 2.6 | < .001 | 8.7 | 4.3 | < .001 |