W-H Lo-Ciganic1, L Floden2, J K Lee3, E L Ashbeck4, L Zhou5, C Chinthammit6, A W Purdy7, C K Kwoh8. 1. Department of Pharmacy, Practice and Science, College of Pharmacy, University of Arizona, Tucson, AZ 85719, USA. Electronic address: lociganic@pharmacy.arizona.edu. 2. Department of Pharmacy, Practice and Science, College of Pharmacy, University of Arizona, Tucson, AZ 85719, USA. Electronic address: libbyford@gmail.com. 3. Department of Pharmacy, Practice and Science, College of Pharmacy, University of Arizona, Tucson, AZ 85719, USA. Electronic address: jlee@pharmacy.arizona.edu. 4. University of Arizona Arthritis Center, College of Medicine, University of Arizona, Tucson, AZ, USA. Electronic address: eashbeck@arthritis.arizona.edu. 5. Department of Pharmacy, Practice and Science, College of Pharmacy, University of Arizona, Tucson, AZ 85719, USA. Electronic address: lilizhou@pharmacy.arizona.edu. 6. Department of Pharmacy, Practice and Science, College of Pharmacy, University of Arizona, Tucson, AZ 85719, USA. Electronic address: chinthammit@pharmacy.arizona.edu. 7. Department of Pharmacy, Practice and Science, College of Pharmacy, University of Arizona, Tucson, AZ 85719, USA. Electronic address: apurdy@email.arizona.edu. 8. University of Arizona Arthritis Center, College of Medicine, University of Arizona, Tucson, AZ, USA; Department of Medicine, Division of Rheumatology, University of Arizona, Tucson, AZ, USA. Electronic address: ckwoh@arthritis.arizona.edu.
Abstract
OBJECTIVE: Few studies have compared the risk of recurrent falls across different types of analgesic use, and with limited adjustment for potential confounders (e.g., pain/depression severity). We assessed analgesic use and the subsequent risk of recurrent falls, among participants with or at risk of knee osteoarthritis (OA). METHODS: A longitudinal analysis included 4231 participants aged 45-79 years at baseline with 4-year follow-up from the Osteoarthritis Initiative (OAI) cohort study. We grouped participants into six mutually exclusive subgroups based on annually assessed analgesic use in the following hierarchical order of analgesic/central nervous system (CNS) potency: use of (1) opioids, (2) antidepressants, (3) other prescription pain medications, (4) over-the-counter (OTC) pain medications, (5) nutraceuticals, and (6) no analgesics. We used multivariable modified Poisson regression models with a robust error variance to estimate the effect of analgesic use on the risk of recurrent falls (≥2) in the following year, adjusted for demographics and health status/behavior factors. RESULTS: Opioid use increased from 2.7% at baseline to 3.6% at the 36-month visit (>80% using other analgesics/nutraceuticals), while other prescription pain medication use decreased from 16.7% to 11.9% over this time period. Approximately 15% of participants reported recurrent falls. Compared to those not using analgesics, participants who used opioids and/or antidepressants had a 22-25% increased risk of recurrent falls (opioids: RRadjusted = 1.22, 95% CI = 1.04-1.45; antidepressants: RRadjusted = 1.25, 95% CI = 1.10-1.41). CONCLUSION: Participants with or at risk of knee OA who used opioids and antidepressants with/without other analgesics/nutraceuticals may have an increased risk of recurrent falls after adjusting for potential confounders. Use of opioids and antidepressants warrants caution. Published by Elsevier Ltd.
OBJECTIVE: Few studies have compared the risk of recurrent falls across different types of analgesic use, and with limited adjustment for potential confounders (e.g., pain/depression severity). We assessed analgesic use and the subsequent risk of recurrent falls, among participants with or at risk of knee osteoarthritis (OA). METHODS: A longitudinal analysis included 4231 participants aged 45-79 years at baseline with 4-year follow-up from the Osteoarthritis Initiative (OAI) cohort study. We grouped participants into six mutually exclusive subgroups based on annually assessed analgesic use in the following hierarchical order of analgesic/central nervous system (CNS) potency: use of (1) opioids, (2) antidepressants, (3) other prescription pain medications, (4) over-the-counter (OTC) pain medications, (5) nutraceuticals, and (6) no analgesics. We used multivariable modified Poisson regression models with a robust error variance to estimate the effect of analgesic use on the risk of recurrent falls (≥2) in the following year, adjusted for demographics and health status/behavior factors. RESULTS: Opioid use increased from 2.7% at baseline to 3.6% at the 36-month visit (>80% using other analgesics/nutraceuticals), while other prescription pain medication use decreased from 16.7% to 11.9% over this time period. Approximately 15% of participants reported recurrent falls. Compared to those not using analgesics, participants who used opioids and/or antidepressants had a 22-25% increased risk of recurrent falls (opioids: RRadjusted = 1.22, 95% CI = 1.04-1.45; antidepressants: RRadjusted = 1.25, 95% CI = 1.10-1.41). CONCLUSION:Participants with or at risk of knee OA who used opioids and antidepressants with/without other analgesics/nutraceuticals may have an increased risk of recurrent falls after adjusting for potential confounders. Use of opioids and antidepressants warrants caution. Published by Elsevier Ltd.
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