Cargando…

Diagnosed Opioid Use Disorder Among Older Adults: Complex Comorbidity and Management Challenges

In the face of a widespread opioid epidemic and many policy changes affecting opioid access and management, it is important to understand the prevalence and characteristics of diagnosed opioid use disorder in older people and their implications for effective management of this high-risk population....

Descripción completa

Detalles Bibliográficos
Autores principales: Treitler, Peter, Crystal, Stephen, Hermida, Richard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7741330/
http://dx.doi.org/10.1093/geroni/igaa057.172
_version_ 1783623728809115648
author Treitler, Peter
Crystal, Stephen
Hermida, Richard
author_facet Treitler, Peter
Crystal, Stephen
Hermida, Richard
author_sort Treitler, Peter
collection PubMed
description In the face of a widespread opioid epidemic and many policy changes affecting opioid access and management, it is important to understand the prevalence and characteristics of diagnosed opioid use disorder in older people and their implications for effective management of this high-risk population. We examined these issues in an ~40% random sample of Medicare beneficiaries with Part D coverage. In 2017, .8% of beneficiaries ages 65+ were diagnosed with OUD (opioid abuse or dependence diagnoses), an increase from .5% in 2015. The late-2015 transition from ICD-9 to ICD-10 may have contributed to this change, but the rate also increased post-ICD-10 by 9.1% from 2016-2017. The profile of individuals diagnosed with OUD reveals a population with complex comorbidity and multiple health challenges: 45% were diagnosed with major depression, 7% with alcohol disorders, 45% with anxiety, 8% with hepatitis C, 26% with cancer, 38% with COPD and 19% with pneumonia (risk factors for opioid overdose), 56% with diabetes and 27% with heart failure. 97% were diagnosed with pain conditions, 85% received opioid prescriptions, and 38% received benzodiazepine prescriptions. These patients represent complex and potentially competing challenges in concurrent management of pain, opioid use disorder, multi-substance use and opioid use disorder. Development of effective, integrated care models to simultaneously address these interrelated problems in this high-risk population should be informed by a closer focus on their multiple needs and monitoring of the adequacy of health system response.
format Online
Article
Text
id pubmed-7741330
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-77413302020-12-21 Diagnosed Opioid Use Disorder Among Older Adults: Complex Comorbidity and Management Challenges Treitler, Peter Crystal, Stephen Hermida, Richard Innov Aging Abstracts In the face of a widespread opioid epidemic and many policy changes affecting opioid access and management, it is important to understand the prevalence and characteristics of diagnosed opioid use disorder in older people and their implications for effective management of this high-risk population. We examined these issues in an ~40% random sample of Medicare beneficiaries with Part D coverage. In 2017, .8% of beneficiaries ages 65+ were diagnosed with OUD (opioid abuse or dependence diagnoses), an increase from .5% in 2015. The late-2015 transition from ICD-9 to ICD-10 may have contributed to this change, but the rate also increased post-ICD-10 by 9.1% from 2016-2017. The profile of individuals diagnosed with OUD reveals a population with complex comorbidity and multiple health challenges: 45% were diagnosed with major depression, 7% with alcohol disorders, 45% with anxiety, 8% with hepatitis C, 26% with cancer, 38% with COPD and 19% with pneumonia (risk factors for opioid overdose), 56% with diabetes and 27% with heart failure. 97% were diagnosed with pain conditions, 85% received opioid prescriptions, and 38% received benzodiazepine prescriptions. These patients represent complex and potentially competing challenges in concurrent management of pain, opioid use disorder, multi-substance use and opioid use disorder. Development of effective, integrated care models to simultaneously address these interrelated problems in this high-risk population should be informed by a closer focus on their multiple needs and monitoring of the adequacy of health system response. Oxford University Press 2020-12-16 /pmc/articles/PMC7741330/ http://dx.doi.org/10.1093/geroni/igaa057.172 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstracts
Treitler, Peter
Crystal, Stephen
Hermida, Richard
Diagnosed Opioid Use Disorder Among Older Adults: Complex Comorbidity and Management Challenges
title Diagnosed Opioid Use Disorder Among Older Adults: Complex Comorbidity and Management Challenges
title_full Diagnosed Opioid Use Disorder Among Older Adults: Complex Comorbidity and Management Challenges
title_fullStr Diagnosed Opioid Use Disorder Among Older Adults: Complex Comorbidity and Management Challenges
title_full_unstemmed Diagnosed Opioid Use Disorder Among Older Adults: Complex Comorbidity and Management Challenges
title_short Diagnosed Opioid Use Disorder Among Older Adults: Complex Comorbidity and Management Challenges
title_sort diagnosed opioid use disorder among older adults: complex comorbidity and management challenges
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7741330/
http://dx.doi.org/10.1093/geroni/igaa057.172
work_keys_str_mv AT treitlerpeter diagnosedopioidusedisorderamongolderadultscomplexcomorbidityandmanagementchallenges
AT crystalstephen diagnosedopioidusedisorderamongolderadultscomplexcomorbidityandmanagementchallenges
AT hermidarichard diagnosedopioidusedisorderamongolderadultscomplexcomorbidityandmanagementchallenges