West Nancy A, Dart Richard C
Research Department, Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, CO, USA.
Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Pharmacoepidemiol Drug Saf. 2016 May;25(5):539-44. doi: 10.1002/pds.3934. Epub 2015 Dec 13.
A high prevalence of chronic pain and high rates of polypharmacy among older adults suggest that this age group may be particularly susceptible to unintentional misuse of prescription opioids. We examined recent trends in misuse of prescription opioids and associated medical outcomes among older-aged adults (60+ years) and compared the patterns with trends among younger-aged adults (20-59 years).
Linear regression trend analysis was used to analyze 57 681 misuse cases reported to participating US poison centers during 2006-2014.
Population rates of misuse of prescription opioids were higher for older adults than for younger adults, and this disparity increased over time. Rates among the older ages increased each year, although the rate of increase slowed over time (p < 0.0001 for negative quadratic trend). In contrast, among the younger adults, there was a significant negative quadratic trend in population rates (p < 0.0001) with a rise in rates during 2006-2010 followed by a decline during 2011-2014. Rates of serious medical outcomes among the older ages followed an increasing linear trend (p < 0.0001); in contrast, rates among younger adults rose and fell during the period, with recent rates trending downward (p < 0.0001 for quadratic trend).
Recent increases in rates of misuse of prescription opioids and associated unfavorable medical outcomes among older adults have important implications as the USA undergoes a rapid expansion of its elderly population. Copyright © 2015 John Wiley & Sons, Ltd.
老年人中慢性疼痛的高患病率和多种药物联合使用的高比例表明，该年龄组可能特别容易无意滥用处方阿片类药物。我们研究了老年人（60岁及以上）处方阿片类药物滥用的近期趋势及相关医疗结局，并将这些模式与年轻人（20 - 59岁）的趋势进行比较。
采用线性回归趋势分析，对2006 - 2014年期间向参与的美国毒物控制中心报告的57681例滥用病例进行分析。
老年人处方阿片类药物的滥用率高于年轻人，且这种差距随时间增加。老年组的滥用率逐年上升，尽管上升速度随时间放缓（负二次趋势，p < 0.0001）。相比之下，年轻人中的滥用率呈现显著的负二次趋势（p < 0.0001），2006 - 2010年期间上升，随后在2011 - 2014年下降。老年人中严重医疗结局的发生率呈线性上升趋势（p < 0.0001）；相比之下，年轻人中的发生率在此期间有升有降，近期发生率呈下降趋势（二次趋势，p < 0.0001）。
在美国老年人口迅速增加的情况下，老年人处方阿片类药物滥用率及相关不良医疗结局的近期上升具有重要意义。版权所有© 2015约翰威立父子有限公司。
