Opioid prescribing among aged care residents during the first year of the COVID-19 pandemic: an analysis using general practice health records in Australia

BMC Geriatrics

Research

Andrew Georgiou¹  Christopher Pearce¹  Nasir Wabe¹  Magdalena Z. Raban¹  Gorkem Sezgin¹  Zhaoli Dai²  Precious McGuire³  Shirmilla Datta³  Richard Woodman⁴ 

[1] Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, 2109, Sydney, NSW, Australia;Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, 2109, Sydney, NSW, Australia;Health Sciences Building, College of Medicine and Public, Health Flinders University, Sturt Road, 5042, Bedford Park, Adelaide, SA, Australia;Eastern Melbourne Primary Health Network, Victoria, Australia;Health Sciences Building, College of Medicine and Public, Health Flinders University, Sturt Road, 5042, Bedford Park, Adelaide, SA, Australia;

关键词: Opioids;    Aged care;    Nursing homes;    Pain management;    General practice;    Primary care, COVID-19;   

DOI  :  10.1186/s12877-023-03821-5

 received in 2022-09-03, accepted in 2023-02-14,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundOpioid use is common among adults 65 years and older, while long-term use of opioids remains controversial and poses risks of drug dependence and other adverse events. The acute disease caused by the SARS-CoV-2 (COVID-19) pandemic has created new challenges and barriers to healthcare access, particularly for long-term care residents. Australia had a relatively low incidence and deaths due to COVID-19 during the first year of the pandemic compared to most OECD countries. In this context, we examined opioid prescribing rates and their dosage in residential aged care facilities (RACFs) before (2019) and during the COVID-19 pandemic (2020) from March to December in Australia.MethodsWe conducted a retrospective cohort using general practice electronic health records. This includes 17,304 RACF residents aged 65 years and over from 361 general practices in New South Wales and Victoria. Number of opioid prescriptions and percentage of opioids over 50 mg/day of oral morphine equivalent (OME) were described. Multivariate generalized estimating equations were applied to estimate odds ratios [aORs (95% confidence intervals)] for 1) opioids prescribed per consultation and 2) prescription opioids over 50 mg/day OME.ResultsIn 2020 among 11,154 residents, 22.8% of 90,897 total prescriptions were opioids, and of the opioids, 11.3% were over 50 mg/day OME. In 2019 among 10,506 residents, 18.8% of 71,829 total prescriptions were opioids, of which 10.3% were over 50 mg/day OME. Year [2020 vs. 2019: aOR (95% CI):1.50 (1.44, 1.56); 1.29 (1.15, 1.46)] and regionality [rural/regional vs. metropolitan: 1.37 (1.26, 1.49); 1.40 (1.14, 1.71)] were associated with higher odds of prescription opioids and OME > 50 mg/day, respectively. Similar results were found when limited to the same residents (n = 7,340) recorded in both years.ConclusionsHigher prescription rates of opioids were observed during the COVID-19 pandemic in 2020 than in 2019 in Australian RACFs. The higher odds of prescription opioids and higher dosing in rural/regional than metropolitan areas indicate a widening of the gap in the quality of pain management during the pandemic. Our findings contribute to the limited data that indicate increased opioid prescriptions in long-term care facilities, likely to continue while COVID-19 pandemic restrictions remain.

【 授权许可】

CC BY   
© The Author(s) 2023

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