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Table 4 Weighted proportion of prescription pain medication use among older patients with chronic pain and with or without ADRD by residential setting

From: Quality of opioid prescribing in older adults with or without Alzheimer disease and related dementia

Medication

Community

 

Nursing home

Weighted proportion among patients with ADRD, %

Weighted proportion among patients without ADRD, %

Proportion difference

(95% CI)a

P-value

Weighted proportion among patients with ADRD, %

Weighted proportion among patients without ADRD, %

Proportion difference

(95% CI)a

P-value

Any use of prescription pain medicationb,c

66.6

67.6

− 1.0 (− 1.4 to − 0.7)

< .001

64.5

74.9

− 10.4 (− 11.7 to − 9.1)

< .001

Opioid

 Any use

45.1

48.1

− 3.0 (− 3.4 to − 2.6)

< .001

47.9

60.7

− 12.8 (− 14.2 to − 11.3)

< .001

 Long-term use of opioidd

41.2

35.7

5.4 (4.9 to 6.0)

< .001

52.5

58.2

− 5.7 (−7.6 to − 3.8)

< .001

Non-opioid

 Any use

30.3

32.7

− 2.4 (− 2.8 to − 2.1)

< .001

18.0

21.9

− 3.9 (− 5.1 to − 2.7)

< .001

Adjuvant analgesic

 Any use

35.9

32.7

3.1 (2.8 to 3.5)

< .001

33.2

40.9

− 7.6 (− 9.1 to − 6.2)

< .001

 SNRI or tricyclic antidepressant

40.0

26.8

13.1 (12.7 to 13.5)

< .001

59.4

53.3

6.1 (4.6 to 7.6)

< .001

 Anticonvulsant

21.1

17.7

3.4 (3.1 to 3.7)

< .001

21.9

27.2

− 5.3 (− 6.7 to − 4.0)

< .001

 Skeletal muscle relaxant

14.2

15.6

− 1.4 (− 1.7 to − 1.2)

< .001

8.2

14.8

− 6.7 (− 7.7 to − 5.6)

< .001

Topical analgesice

8.1

6.6

1.5 (1.3 to 1.7)

< .001

8.8

11.9

− 3.0 (− 4.0 to − 2.1)

< .001

  1. Abbreviations: ADRD Alzheimer disease and related dementias, SNRI serotonin-norepinephrine reuptake inhibitor
  2. aProportion difference between patients with or without ADRD was estimated with generalized linear models with weight statement (to incorporate inverse probability weighting that balances differences in baseline characteristics between the ADRD and non-ADRD groups)
  3. bUse of prescription pain medications was measured during the 12 months after diagnosis of chronic pain, which was randomly selected per patient
  4. cA patient may have more than 1 type of drug combination during the 12-month observation period
  5. dThe proportion was calculated among opioid users
  6. ePrescription topical analgesics included diclofenac and lidocaine