Aya Yoshikawa1, Gilbert Ramirez2, Matthew Lee Smith1,3,4, Margaret Foster5, Anas K Nabil2, Sagar N Jani1,6, Marcia G Ory1,3. 1. Center for Population Health and Aging, Texas A&M University, College Station. 2. Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station. 3. Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station. 4. Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens. 5. Medical Sciences Library, Texas A&M University, College Station. 6. Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station.
Abstract
BACKGROUND: There is increasing concern about opioid use as a pain treatment option among older adults. Existing literature implies an association between opioid use and fracture, increasing the risk of death and disabilities; yet, this relationship with other fall-related outcomes has not been fully explored. We performed a meta-analysis to evaluate the associations between opioid use and adverse health outcomes of falls, fall injuries, and fractures among older adults. METHODS: A systematic literature search was conducted using nine databases: Medline, Embase, CINAHL, PsycInfo, Global Health, Northern Light Sciences Conference Abstracts, Cochrane CENTRAL, WHO International Clinical Trials Registry Platform, and ClinicalTrials.gov. We log-transformed effect sizes (relative risk [RR], odds ratio [OR], and hazard ratio [HR]) to compute pooled risk estimates comparable across the studies. The random-effects model was applied to calculate the pooled risk estimates due to heterogeneity. Meta-regressions explored differences in risk estimates by analysis method, study design, setting, and study quality. RESULTS: Thirty studies, providing 34 relevant effect sizes, met the inclusion criteria for this meta-analysis. Overall, opioid use was significantly associated with falls, fall injuries, and fractures, with effect sizes ranging from 0.15 to 0.71. In meta-regressions, no selected factors explained heterogeneity. CONCLUSION: While heterogeneity is present, results suggest an increased risk of falls, fall injuries, and fractures among older adults who used opioids. Findings highlight the need for opioid education and nonopioid-related pain management interventions among older adults to decrease fall-related risk. Published by Oxford University Press on behalf of The Gerontological Society of America 2020.
BACKGROUND: There is increasing concern about opioid use as a pain treatment option among older adults. Existing literature implies an association between opioid use and fracture, increasing the risk of death and disabilities; yet, this relationship with other fall-related outcomes has not been fully explored. We performed a meta-analysis to evaluate the associations between opioid use and adverse health outcomes of falls, fall injuries, and fractures among older adults. METHODS: A systematic literature search was conducted using nine databases: Medline, Embase, CINAHL, PsycInfo, Global Health, Northern Light Sciences Conference Abstracts, Cochrane CENTRAL, WHO International Clinical Trials Registry Platform, and ClinicalTrials.gov. We log-transformed effect sizes (relative risk [RR], odds ratio [OR], and hazard ratio [HR]) to compute pooled risk estimates comparable across the studies. The random-effects model was applied to calculate the pooled risk estimates due to heterogeneity. Meta-regressions explored differences in risk estimates by analysis method, study design, setting, and study quality. RESULTS: Thirty studies, providing 34 relevant effect sizes, met the inclusion criteria for this meta-analysis. Overall, opioid use was significantly associated with falls, fall injuries, and fractures, with effect sizes ranging from 0.15 to 0.71. In meta-regressions, no selected factors explained heterogeneity. CONCLUSION: While heterogeneity is present, results suggest an increased risk of falls, fall injuries, and fractures among older adults who used opioids. Findings highlight the need for opioid education and nonopioid-related pain management interventions among older adults to decrease fall-related risk. Published by Oxford University Press on behalf of The Gerontological Society of America 2020.
Authors: Hemalkumar B Mehta; Yong-Fang Kuo; Mukaila Raji; Shuang Li; Jordan Westra; James S Goodwin Journal: J Am Med Dir Assoc Date: 2020-06-27 Impact factor: 4.669
Authors: Hemalkumar B Mehta; Yong-Fang Kuo; Mukaila A Raji; Jordan Westra; Cynthia Boyd; G Caleb Alexander; James S Goodwin Journal: J Am Med Dir Assoc Date: 2021-05-19 Impact factor: 4.669
Authors: Noman Dormosh; Martijn C Schut; Martijn W Heymans; Nathalie van der Velde; Ameen Abu-Hanna Journal: J Gerontol A Biol Sci Med Sci Date: 2022-07-05 Impact factor: 6.591