Factors associated with daily opioid use among aged home care clients: a cross-sectional analysis of Resident Assessment Instrument data

Heidi Mörttinen-Vallius, Sirpa Hartikainen, Heini Huhtala, Lauri Seinelä, Esa Jämsen

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Purpose: To examine which client characteristics and other factors, including possible adverse effects, identified in the Resident Assessment Instrument—Home Care (RAI-HC) are associated with daily opioid use among aged home care clients. Methods: The study sample comprised 2584 home care clients aged ≥ 65 years, of which 282 persons used opioids daily. Clients using opioids less than once daily were excluded. The cross-sectional data were gathered from each client’s first assessment with the RAI-HC during 2014. Multivariable logistic regression was used to study associations of daily opioid use with the clients’ characteristics and symptoms. Results: Cognitive impairment was associated with less frequent opioid use after adjusting for pain-related diseases, disabilities and depressive symptoms (OR 0.43, 95% CI 0.32–0.58). The association was not explained by the estimated severity of pain. Osteoporosis, cancer within previous 5 years and greater disabilities in Instrumental Activities of Daily Living (IADL) were associated with daily opioid use regardless of the estimated severity of pain. Depressive symptoms and Parkinson’s disease were associated with daily opioid use only among clients with cognitive impairment, and disabilities in Activities of Daily Living, cancer, arthritis, fractures and pressure ulcers only among clients without cognitive impairment. Constipation was the only adverse effect associated with daily opioid use. Conclusion: The pain of home care clients with cognitive impairment may not be treated optimally, whereas there might be prolonged opioid use without a sufficient evaluation of current pain among clients with osteoporosis, cancer within previous 5 years and disabilities in IADLs.

Original languageEnglish
JournalEUROPEAN GERIATRIC MEDICINE
DOIs
Publication statusE-pub ahead of print - Jul 2021
Publication typeA1 Journal article-refereed

Keywords

  • Aged
  • Cognitive impairment
  • Home care
  • Opioids
  • Resident Assessment Instrument

Publication forum classification

  • Publication forum level 1

ASJC Scopus subject areas

  • Gerontology
  • Geriatrics and Gerontology

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