Mullachery Pricila H, Lima-Costa Maria Fernanda, de Loyola Filho Antônio Ignácio
Department of Health Services Administration and Policy, Temple University College of Public Health, Philadelphia, PA, USA.
Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, MG, Brazil.
Lancet Reg Health Am. 2023 Mar 1;20:100459. doi: 10.1016/j.lana.2023.100459. eCollection 2023 Apr.
Pain has a significant impact on people's quality of life. The use of prescription opioids to treat pain is associated with an increased risk of opioid use disorders and overdose death. We measured the prevalence of recurrent pain, prescription opioid use, and associations between chronic conditions and prescription opioid use among Brazilian older adults.
We used data from the first population-based longitudinal study of aging in Brazil (ELSI-Brazil), 2019-2020 (mean age = 63.3; 54.4% female). Outcomes were: (1) experience of recurrent pain and (2) use of opioid analgesics in the past three months among those who experience pain. Exposures included selected health conditions, history of falls, and hospitalizations.
Prevalence of pain (n = 9234) was 36.9% (95% CI: 32.6-41.1). Pain was reported more frequently by female participants, low-income individuals, and those with a previous diagnosis of arthritis, chronic back pain, depressive symptoms, history of falls, and hospitalizations. Prevalence of opioid use among those reporting pain (n = 3350) was 30% (95% CI: 23.1-38.0). Prevalence of opioid use was higher among female and single individuals. In adjusted models, arthritis, chronic back pain, and presence of depressive symptoms were associated with prescription opioid use.
Prescription opioid use was reported by a sizable portion of the older adults who suffer from pain in Brazil. In a context of growing consumption of prescription opioids, opioid misuse has the potential to increase in the future. Surveillance of prescription opioid use is critical to prevent their harmful consequences.
ELSI-Brazil was funded by the Brazilian Ministry of Health.
疼痛对人们的生活质量有重大影响。使用处方阿片类药物治疗疼痛与阿片类药物使用障碍和过量死亡风险增加有关。我们测量了巴西老年人复发性疼痛的患病率、处方阿片类药物的使用情况以及慢性病与处方阿片类药物使用之间的关联。
我们使用了巴西首次基于人群的老龄化纵向研究(ELSI - 巴西)2019 - 2020年的数据(平均年龄 = 63.3岁;54.4%为女性)。结局指标为:(1)复发性疼痛经历;(2)在经历疼痛的人群中过去三个月内阿片类镇痛药的使用情况。暴露因素包括选定的健康状况、跌倒史和住院史。
疼痛患病率(n = 9234)为36.9%(95%置信区间:32.6 - 41.1)。女性参与者、低收入个体以及既往诊断有关节炎、慢性背痛、抑郁症状、跌倒史和住院史的人报告疼痛的频率更高。报告疼痛的人群中阿片类药物使用患病率(n = 3350)为30%(95%置信区间:23.1 - 38.0)。女性和单身人士的阿片类药物使用患病率更高。在调整模型中,关节炎、慢性背痛和抑郁症状的存在与处方阿片类药物的使用有关。
在巴西,相当一部分患有疼痛的老年人报告使用了处方阿片类药物。在处方阿片类药物消费不断增加的背景下,未来阿片类药物滥用有可能增加。监测处方阿片类药物的使用对于预防其有害后果至关重要。
ELSI - 巴西由巴西卫生部资助。