Patterns and variation of opioid use in long-stay nursing home residents with dementia

患有痴呆症的长期入住疗养院居民的阿片类药物使用模式和变化

基本信息

批准号：
9719244
负责人：
Yong-Fang Kuo
金额：
$ 24.46万
依托单位：
UNIVERSITY OF TEXAS MED BR GALVESTON
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-15 至 2020-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9719244
关键词：
Abbreviations Address Administrative Supplement Adverse effects Analgesics Antibiotics Antidepressive Agents Antipsychotic Agents Benefits and Risks Certification Characteristics Clinical Confidence Intervals Country Current Procedural Terminology Data Data Set Dementia Diagnosis-Related Groups Dose Drug Prescriptions Effectiveness Elderly Ensure Equilibrium European Evaluation Event Fentanyl Grant Guidelines Health Maintenance Organizations Healthcare Common Procedure Coding System Home Nursing Care ICD-9-CM International Classification of Diseases Knowledge Link Logistic Regressions Long-Term Care Long-Term Care Nursing Medicare Medicare claim Modeling Modification Morphine Morphine Sulfate Nursing Homes Odds Ratio Operative Surgical Procedures Opioid Outpatients Pain Pain management Patients Pattern Pharmaceutical Preparations Physicians Policies Population Prevalence Provider Public Health Reporting Research Retrospective cohort study Safety Surveys United States United States Centers for Medicare and Medicaid Services Variant beneficiary experience milligram nursing home length of stay opioid epidemic opioid use pain relief patient variability prescription opioid statistics virtual

项目摘要

ABSTRACT Dementia and the opioid epidemic are two escalating public health challenges in the US. Over half of those with dementia regularly experience pain. Despite improvement in pain recognition and treatment among older adults, dementia patients are less likely than those without dementia to receive appropriate pain medication. Opioid use has quadrupled in the last decade, with over one third of nursing home residents prescribed opioids. Prior studies have shown variations in medication use (for antipsychotics, antidepressants, antibiotics and statins) across nursing homes. It is unknown how opioids are used for pain management in nursing home residents with dementia and if such use varies across nursing homes. To address this research gap, we propose to conduct a nationally representative study to examine the use of opioids in nursing home residents with dementia. Our specific aims are: 1. Describe the prevalence, duration, and dose of opioid use among long-term care nursing home residents with dementia, related to their pain level. 2. Compare the rate of opioid use among long-term care nursing home residents with dementia to that of residents without dementia. 3. Determine the variation in opioid use across nursing homes among long-term care residents with dementia and identify the patient, prescriber and facility level characteristics associated with this variation. We will use the Minimum Data Set and Medicare claims data from 2008 to 2016 for this study. This research will provide policy-relevant and clinically useful information to ensure the safe and effective use of opioids in nursing home residents with dementia.

抽象的痴呆症和阿片类药物流行是美国面临的两大公共卫生挑战。其中一半以上痴呆症患者经常会感到疼痛。尽管老年人的疼痛识别和治疗有所改善成年人中，痴呆症患者比没有痴呆症的患者接受适当的止痛药物的可能性较小。过去十年中，阿片类药物的使用量增加了四倍，超过三分之一的疗养院居民服用了阿片类药物阿片类药物。先前的研究表明药物使用的差异（抗精神病药、抗抑郁药、抗生素和他汀类药物）遍布疗养院。目前尚不清楚疗养院如何使用阿片类药物来治疗疼痛患有痴呆症的居民以及不同疗养院的这种使用情况是否有所不同。为了弥补这一研究空白，我们提议进行一项全国代表性研究，以调查疗养院居民使用阿片类药物的情况患有痴呆症。我们的具体目标是： 1. 描述阿片类药物使用的流行率、持续时间和剂量患有痴呆症的长期护理疗养院居民，与他们的疼痛程度有关。 2. 比较阿片类药物的费率患有痴呆症的长期护理疗养院居民与没有痴呆症的居民的使用情况。 3. 确定各疗养院中患有痴呆症的长期护理居民中阿片类药物使用的差异识别与这种变化相关的患者、处方者和设施水平特征。我们将使用本研究的最低数据集和 2008 年至 2016 年医疗保险索赔数据。这项研究将提供政策相关和临床有用的信息，以确保在疗养院安全有效地使用阿片类药物患有痴呆症的居民。