The Effect of Concurrent Use of Opioids and Gabapentin on Fall Risk in Older Adults.

Jacob T Painter, Cheng Peng, Mary Burlette, Callie Clement, Lisa Luciani, Gohar Azhar, Lindsey Dayer
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Abstract

Falls pose a significant threat to older adults, resulting in injuries and mortality. Concurrently prescribed opioids and gabapentin for pain management may increase fall risks in older patients. This study aimed to estimate fall risks associated with the concurrent use of gabapentin and opioids, comparing them to opioid monotherapy in older adults. A retrospective case-control study of 1,813 patients aged 65-89 on chronic opioid therapy (2017-2020), excluding those with a fall history, analysis focused on the first fall occurrence. Logistic regression assessed the association between concurrent gabapentin and opioid use and fall events. Out of eligible patients, 122 (6.73%) experienced falls during opioid therapy, with 232 (12.80%) having concurrent gabapentin use. Concurrent use significantly increased fall risk (AOR = 1.73; 95% CI: 1.08-2.78). Being female, aged ≥81, and having more chronic conditions also increased risk. Mitigating fall risk in older adults requires education on prevention, exploring alternative pain management, and careful consideration of prescribing. Further research is crucial to understand adverse events linked to combined opioid and gabapentin use in the geriatric population.

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同时使用阿片类药物和加巴喷丁对老年人跌倒风险的影响
跌倒对老年人构成重大威胁,会导致受伤和死亡。同时使用阿片类药物和加巴喷丁治疗疼痛可能会增加老年患者跌倒的风险。本研究旨在估算与同时使用加巴喷丁和阿片类药物相关的跌倒风险,并将其与老年阿片类药物单药治疗进行比较。该研究是一项回顾性病例对照研究,研究对象为1813名年龄在65-89岁之间、正在接受阿片类药物慢性治疗的患者(2017-2020年),排除了有跌倒史的患者,分析重点为首次跌倒发生情况。逻辑回归评估了同时使用加巴喷丁和阿片类药物与跌倒事件之间的关联。在符合条件的患者中,有 122 人(6.73%)在阿片类药物治疗期间发生过跌倒,其中 232 人(12.80%)同时使用了加巴喷丁。同时使用可明显增加跌倒风险(AOR = 1.73;95% CI:1.08-2.78)。女性、年龄≥81 岁和患有更多慢性疾病也会增加风险。要降低老年人的跌倒风险,就必须开展预防教育、探索替代性疼痛治疗方法并慎重考虑处方。要了解在老年人群中联合使用阿片类药物和加巴喷丁的不良反应,进一步的研究至关重要。
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来源期刊
CiteScore
1.60
自引率
9.10%
发文量
40
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