Nazmin Farhana, Nath Tuheen Sankar, Limbaña Therese Anne, Murugan Vignesh, Garcia Jian, Singareddy Sanjana
Psychiatry, BronxCare Health System, Bronx, USA.
Surgical Oncology, Tata Medical Center, Kolkata, IND.
Cureus. 2024 Sep 7;16(9):e68910. doi: 10.7759/cureus.68910. eCollection 2024 Sep.
Opioid dependence is a serious public health concern, particularly for older individuals who have a high prevalence of comorbid conditions. To effectively manage opioid use disorder (OUD), methadone maintenance treatment (MMT) is crucial; however, the MMT poses certain challenges for the aging population. The purpose of this review is to evaluate the impact of MMT on health outcomes, identify predictive factors for mortality, and assess mortality rates among older individuals receiving MMT. A systematic search was performed across databases, including PubMed, Scopus, Web of Science, and Google Scholar, adhering to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Studies included were published between January 2000 and December 2023, focused on elderly patients (60 years of age and older) receiving MMT and provided information on death rates. A total of 15 studies were examined. The main causes of death for older MMT patients were overdose, respiratory issues, and cardiovascular diseases. The annual mortality rates for these patients ranged from 2% to 10%. Treatment outcomes and mortality were significantly impacted by comorbid conditions. Greater treatment adherence and longer care periods were observed in older individuals, which correlated with better health outcomes and lower mortality. This review makes clear how elderly MMT patients with addiction and chronic health issues require integrated care models. Treatment effectiveness may be further increased by gender-specific interventions. For this aging population, policy reforms and enhanced healthcare support are essential. To enhance clinical results and lower mortality rates among older individuals enrolled in MMT programs, comprehensive age-appropriate care models are crucial. Long-term health outcomes should be investigated further and evidence-based treatments for older individuals with OUD should be developed.
阿片类药物依赖是一个严重的公共卫生问题,尤其是对于患有合并症比例较高的老年人来说。为了有效管理阿片类药物使用障碍(OUD),美沙酮维持治疗(MMT)至关重要;然而,MMT对老年人群体带来了一定挑战。本综述的目的是评估MMT对健康结局的影响,确定死亡率的预测因素,并评估接受MMT的老年人的死亡率。我们按照系统评价和Meta分析的首选报告项目(PRISMA)指南,在包括PubMed、Scopus、科学网和谷歌学术在内的数据库中进行了系统检索。纳入的研究发表于2000年1月至2023年12月之间,聚焦于接受MMT的老年患者(60岁及以上),并提供了死亡率信息。共审查了15项研究。老年MMT患者的主要死亡原因是药物过量、呼吸问题和心血管疾病。这些患者的年死亡率在2%至10%之间。合并症对治疗结局和死亡率有显著影响。在老年人中观察到更高的治疗依从性和更长的护理期,这与更好的健康结局和更低的死亡率相关。本综述明确了患有成瘾和慢性健康问题的老年MMT患者如何需要综合护理模式。针对性别的干预措施可能会进一步提高治疗效果。对于这一老年人群体,政策改革和加强医疗支持至关重要。为了提高接受MMT项目的老年人的临床效果并降低死亡率,全面的适合年龄的护理模式至关重要。应进一步研究长期健康结局,并为患有OUD的老年人开发基于证据的治疗方法。