Axon David R, Maldonado Taylor
Department of Pharmacy Practice & Science, R. Ken Coit College of Pharmacy, The University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85721, USA.
Center for Health Outcomes and PharmacoEconomic Research (HOPE Center), R. Ken Coit College of Pharmacy, The University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85721, USA.
Healthcare (Basel). 2023 Jul 12;11(14):2010. doi: 10.3390/healthcare11142010.
The number of older United States (US) adults is increasing, yet extra life years are not always spent in good health. This study explored the relationship between pain intensity and health status among US adults aged ≥50 with pain who used an opioid in the 2020 Medical Expenditure Panel Survey using multivariable logistic regression adjusting for demographic, economic, and health variables. Most (60.2%) older US adult opioid users with pain reported having good health (versus 39.8% poor health). In the fully adjusted analysis, those with extreme pain (odds ratio (OR) = 0.19, 95% confidence interval (CI) = 0.10, 0.35) and quite a bit of pain (OR = 0.34, 95% CI = 0.19, 0.60) had lower odds of reporting good health compared to those with little pain. There was no statistical relationship between health status for moderate versus little pain. In addition, males (versus females; OR = 0.61, 95% CI = 0.40, 0.91), white race (versus not white; OR = 0.43, 95% CI = 0.22, 0.84), education ≤high school (versus >high school; OR = 0.61, 95% CI = 0.41, 0.92), and current smoker (versus non-smoker; OR = 0.55, 95% CI = 0.32, 0.93) were associated with lower odds of reporting good health. Being employed (versus unemployed; OR = 1.88, 95% CI = 1.06, 3.33), having <2 chronic conditions (versus ≥2; OR = 4.38, 95% CI = 1.91, 10.02), and doing regular physical activity (versus not; OR = 2.69, 95% CI = 1.73, 4.19) were associated with higher odds of reporting good health. These variables should be considered when assessing the health needs and developing treatment plans for older US adult opioid users with pain.
美国老年成年人的数量正在增加，但额外的生命年并非总是在健康状态下度过。本研究在2020年医疗支出面板调查中，使用多变量逻辑回归对人口统计学、经济和健康变量进行调整，探讨了年龄≥50岁且使用阿片类药物的疼痛美国成年人中疼痛强度与健康状况之间的关系。大多数（60.2%）患有疼痛的美国老年阿片类药物使用者报告健康状况良好（相比之下，健康状况不佳的占39.8%）。在完全调整分析中，与疼痛轻微的人相比，疼痛剧烈的人（优势比（OR）=0.19，95%置信区间（CI）=0.10，0.35）和疼痛较为严重的人（OR = 0.34，95% CI = 0.19，0.60）报告健康状况良好的几率较低。中度疼痛与轻微疼痛的健康状况之间无统计学关系。此外，男性（与女性相比；OR = 0.61，95% CI = 0.40，0.91）、白人（与非白人相比；OR = 0.43，95% CI = 0.22，0.84）、教育程度≤高中（与>高中相比；OR = 0.61，95% CI = 0.41，0.92）以及当前吸烟者（与非吸烟者相比；OR = 0.55，95% CI = 0.32，0.93）报告健康状况良好的几率较低。就业（与失业相比；OR = 1.88，95% CI = 1.06，3.33）、患有<2种慢性病（与≥2种相比；OR = 4.38，95% CI = 1.91，10.02）以及进行定期体育活动（与不进行相比；OR = 2.69，95% CI = 1.73，4.19）与报告健康状况良好的几率较高相关。在评估患有疼痛的美国老年阿片类药物使用者的健康需求和制定治疗计划时，应考虑这些变量。
