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- W2980347875 abstract "Pain may be under recognized and undertreated in dementia patients. We examined the prevalence, duration, and type of opioid use among long-term care nursing home residents with dementia. This retrospective cohort study used Minimum Data Set linked Medicare data, 2011-2016, and included long-term care episodes for residents 65+ years who survived 100+ days each year (592,211 episodes for 256,207 residents). Cognitive status at first annual assessment was classified as none/mild, moderate and severe impairment. Overall opioid use, prolonged opioid use (prescription supply 90+ days) and long-acting opioid use were identified from Medicare part D. Descriptive statistics were used to describe opioid use by cognitive impairment. Cochrane Armitage trends test was used to determine trends in opioid use. Three separate logistic regression models were constructed to determine the association of cognitive impairment with any opioid use, prolonged opioid use and long-acting opioid use after controlling for age, race, region and pain level. 114,622 (19%) patients had severe and 129,257 (22%) had moderate dementia. Overall opioid (none/mild=15.4%, moderate=13.9%, severe=9%), prolonged opioid (none/mild=5.2%, moderate=4.5%, severe=3.2%) and long-acting opioid use (none/mild=1.1%, moderate=0.9%, severe=0.3% ) were lower in patients with advanced dementia. Substantial increase was found in overall opioid and prolonged opioid use from 2011 to 2016, with greater increase in none/mild and moderate dementia patients. For example, prolonged opioid use increased by 69% in none/mild and 71% in moderate dementia patients compared to 52% in severe dementia patients (p<0.0001). Long-acting opioid use decreased, with a greater decline in none/mild (69%) and moderate (71%) dementia patients compared to severe dementia patients (58%) (p<0.0001). In logistic regression models, patient with moderate and severe cognitive impairment were associated with lower use of any opioid, prolonged opioid and long-acting opioid (Table 1)." @default.
- W2980347875 created "2019-10-25" @default.
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- W2980347875 date "2019-07-01" @default.
- W2980347875 modified "2023-09-27" @default.
- W2980347875 title "P4-634: ASSOCIATION OF DEMENTIA SEVERITY AND OPIOID USE IN LONG-TERM CARE NURSING HOME RESIDENTS WITH DEMENTIA" @default.
- W2980347875 doi "https://doi.org/10.1016/j.jalz.2019.08.183" @default.
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