Increasing Rates of Opioid Misuse Among Older Adults Visiting Emergency Departments
Increasing Rates of Opioid Misuse Among Older Adults Visiting Emergency Departments
复制标题
DOI：
10.1093/geroni/igz002
复制
发表时间：
2019-01-01
影响因子：
7
通讯作者：
Kabel, Allison
中科院分区：
文献类型：
--
作者：
Carter, Mary W.;Yang, Bo Kyum;Kabel, Allison
目的：本研究旨在探讨阿片类药物滥用相关的急诊科（艾德）访问老年人和与这些访问的结果的变化相关的因素，使用多年的全国代表性data.Methods：全国急诊科样本进行了回顾性分析。研究入选仅限于65岁及以上的成年人。诊断代码用于识别阿片类药物滥用障碍;抽样权重用于调整误差的标准估计值。描述性和多变量程序被用来描述风险和访问outcome.Results：艾德访问的老年人阿片类药物滥用确定的艾德急剧增加，从2006年至2014年，在研究期间增加了近220%。阿片类药物滥用与慢性疾病数量的增加、更大的伤害风险以及更高的酒精依赖和精神健康诊断率相关。在老年人艾德就诊中观察到的阿片类药物滥用急剧增加，这强调了迫切需要进行额外的研究，以更好地了解阿片类药物滥用对老年人的全国范围和影响，以及更好地为政策反应提供信息，以满足这一特定年龄组的需求。研究结果表明，在急诊科就诊的老年人中，阿片类药物滥用和依赖的广度和范围，并表明针对性的筛查，干预，特别是针对老年人的治疗是有必要的。这项研究的结果还强调了在这一人群中治疗阿片类药物依赖的复杂性，这部分反映了精神健康和其他药物滥用障碍并存的高比率。综合考虑，这些调查结果强调迫切需要改变政策，以增加获得长期药物滥用治疗和支持的机会。
Objective: This study sought to investigate factors associated with opioid misuse-related emergency department (ED) visits among older adults and changes in outcomes associated with these visits, using multiple years of nationally representative data.Methods: A retrospective analysis of the Nationwide Emergency Department Sample was conducted. Study inclusion was limited to adults aged 65 years and older. Diagnostic codes were used to identify opioid misuse disorder; sampling weights were used to adjust standard estimates of the errors. Descriptive and multivariate procedures were used to describe risk and visit outcomes.Results: ED visits by older adults with opioid misuse identified in the ED increased sharply from 2006 to 2014, representing a nearly 220% increase over the study period. Opioid misuse was associated with an increased number of chronic conditions, greater injury risk, and higher rates of alcohol dependence and mental health diagnoses.Conclusion: The steep increase in opioid misuse observed among older adult ED visits underscores the critical need for additional research to better understand the national scope and impact of opioid misuse on older adults, as well as to better inform policy responses to meet the needs of this particular age group.Translational Significance: Findings demonstrate the breadth and scope of opioid misuse and dependence among older adults visiting emergency departments and indicate that targeted programs aimed at screening, intervention, and treatment specifically geared toward older adults are warranted. Results from this study also highlight the complexity of treating opioid dependence in this population, which reflect in part, high rates of coexisting mental health and other substance abuse disorders. When considered together, these findings underscore the pressing need for policy changes to increase access to long-term substance misuse treatment and support needs.