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Br J Clin Pharmacol. 2016 Jan;81(1):161-70. doi: 10.1111/bcp.12762. Epub 2015 Oct 2.

Incident opioid drug use among older adults with chronic obstructive pulmonary disease: a population-based cohort study.

Author information

1
Division of Respirology, Department of Medicine, St Michael's Hospital, Toronto, Ontario, Canada.
2
Keenan Research Centre in the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.
3
Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
4
Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
5
Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.
6
Division of Respirology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
7
Division of General Internal Medicine, Department of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.
8
Department of Medicine, Queen's University, Kingston, Ontario, Canada.
9
Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.

Abstract

AIMS:

The purpose of the present study was to describe the scope, pattern and patient characteristics associated with incident opioid use among older adults with chronic obstructive pulmonary disease (COPD).

METHODS:

This was a retrospective population-based cohort study using Ontario, Canada, healthcare administrative data. Study participants were individuals aged 66 years and older with physician-diagnosed COPD, identified using a validated algorithm, who were not receiving palliative care. We examined the incidence of oral opioid receipt between 1 April 2003 and 31 March 2012, as well as several patterns of incident opioid drug use.

RESULTS:

Among 107,109 community-dwelling and 16,207 long-term care resident older adults with COPD, 72,962 (68.1%) and 8811 (54.4%), respectively, received an incident opioid drug during the observation period. Among long-term care residents, multiple opioid dispensings (8.8%), dispensings for >30 days' duration (up to 19.8%), second dispensings (35-43%) and early refills (24.2%) were observed. Incident opioid dispensing was also observed to occur during COPD exacerbations (6.9% among all long-term care residents; 18.1% among long-term care residents with frequent exacerbations). These same patterns of incident opioid use occurred among community-dwelling individuals, but with relatively lower frequencies.

CONCLUSIONS:

New opioid use was high among older adults with COPD. Potential safety concerns are raised by the degree and pattern of new opioid use, but further studies are needed to evaluate if adverse events are associated with opioid drug use in this older and respiratory-vulnerable population.

KEYWORDS:

COPD; elderly; narcotics; opioids; pharmacoepidemiology

PMID:
26337922
PMCID:
PMC4693564
DOI:
10.1111/bcp.12762
[Indexed for MEDLINE]
Free PMC Article

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