Associate Professor Emeritus, University of Connecticut, Storrs, Connecticut.
J Am Assoc Nurse Pract. 2022 Aug 1;34(8):968-977. doi: 10.1097/JXX.0000000000000734.
Factors predictive of chronic pain in older adults could help focus prevention and treatment efforts for those most at risk of chronic pain.
The objective of the study was to describe demographic and pain self-management factors predictive of chronic pain in the context of opioid adverse drug events (ADEs) reported for a cohort of older adults within the same year.
The design was a post hoc analysis of 9,095 cases aged 65 years and older from the 2019 National Health Interview Survey that reported chronic pain and 380 cases aged 65 years and older with opioid adverse events reported to the Food and Drug Administration Adverse Event Reporting System (FAERS) during the second quarter of 2019. Logistic regression predicted chronic pain.
Less than a baccalaureate education increased the odds of chronic pain by 28.0% while lower income minimally increased the odds. Male gender increased the odds of chronic pain by 12.0%. Increased age minimally increased the odds for chronic pain. Use of opioids, other pain treatments, complementary treatments, and antidepressants were all associated with increased odds of chronic pain. FAERS opioid ADEs ranged from pruritus to death, with death identified in 16 (4.2%) cases. Misuse, abuse, or dependence was documented in 1.8% of cases.
Less-educated older adults may be particularly at risk of chronic pain and should be routinely assessed and prescribed safe and efficacious pain self-management as needed. Some men may need additional support to use pain treatments.
预测老年人慢性疼痛的因素可以帮助将预防和治疗工作集中在最容易发生慢性疼痛的人群上。
本研究旨在描述人口统计学和疼痛自我管理因素，这些因素与同年报告的老年人群中阿片类药物不良反应事件（ADEs）相关，预测慢性疼痛。
这是对 2019 年全国健康访谈调查中报告慢性疼痛的 9095 例 65 岁及以上患者和 2019 年第二季度向食品和药物管理局不良事件报告系统（FAERS）报告的 380 例 65 岁及以上阿片类药物 ADEs 的回顾性分析。Logistic 回归预测慢性疼痛。
未获得学士学位教育使慢性疼痛的可能性增加了 28.0%，而收入较低则略微增加了可能性。男性增加了慢性疼痛的可能性 12.0%。年龄的增加使慢性疼痛的可能性略有增加。使用阿片类药物、其他疼痛治疗方法、补充治疗和抗抑郁药都与增加慢性疼痛的可能性相关。FAERS 阿片类药物 ADEs 从瘙痒到死亡不等，16 例（4.2%）死亡。在 1.8%的病例中记录了误用、滥用或依赖。
受教育程度较低的老年人可能特别容易发生慢性疼痛，应定期进行评估，并根据需要开具安全有效的疼痛自我管理处方。一些男性可能需要额外的支持来使用疼痛治疗方法。
