ArticleJournal of the American Medical Directors Association2021
Time Trends in Opioid Use by Dementia Severity in Long-Term Care Nursing Home Residents.
Article in Journal of the American Medical Directors Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- A systematic review of opioid prevalence in Australian residential aged care facilities.Australasian journal on ageing · 2022Pooled it
- The impact of opioid prescribing guidelines on opioid dispensation: A systematic review and meta-analysis.Canadian journal of pain = Revue canadienne de la douleur · 2026Review
- Rates and predictors of opioid deprescribing after fracture: A retrospective study of Medicare fee-for-service claims.Journal of the American Geriatrics Society · 2025Article
- Comparison of opioid use among long-term care residents in Ontario and Alberta, Canada: A multi-jurisdictional, repeated cross-sectional study.Canadian journal of pain = Revue canadienne de la douleur · 2025Article
- Comparative Effectiveness and Safety of Direct Oral Anticoagulants vs Warfarin among Nursing Home Residents with Atrial Fibrillation: A Retrospective Cohort Study.Journal of the American Medical Directors Association · 2024Article
- Prevalence of Opioid Use in Nursing Homes Over the Last Decade: A Systematic Literature Review.The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians · 2024Article
- Comparative safety of adding serotonin and norepinephrine reuptake inhibitors (SNRIs) versus nonsteroidal anti-inflammatory drugs (NSAIDs) to short-acting opioids for non-malignant pain in nursing homes.Journal of the American Geriatrics Society · 2023Article
- Nursing Home Characteristics Associated with High and Low Levels of Antipsychotic, Benzodiazepine, and Opioid Prescribing to Residents with Alzheimer's Disease and Related Dementias: A Cross-Sectional Analysis.Journal of the American Medical Directors Association · 2022Article
- Correlates of Opioid Use Among Ontario Long-Term Care Residents and Variation by Pain Frequency and Intensity: A Cross-sectional Analysis.Drugs & aging · 2022Article
- Discontinuation of Long-Term Opioid Therapy in Patients With Versus Without Dementia.American journal of preventive medicine · 2022Article
- State Variation in Chronic Opioid Use in Long-Term Care Nursing Home Residents.Journal of the American Medical Directors Association · 2021Article
- Article
- Are Chronic Pain Patients with Dementia Being Undermedicated?Journal of pain research · 2021Review
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveCurrent information on opioid use in nursing home residents, particularly those with dementia, is unknown. We examined the temporal trends in opioid use by dementia severity and the association of dementia severity with opioid use in long-term care nursing home residents.
designRepeated measures cross-sectional study.
settingLong-term care nursing homes.
participantsUsing 20% Minimum Data Set (MDS) and Medicare claims from 2011-2017, we included long-term care residents (n = 734,739) from each year who had 120 days of consecutive stay. In a secondary analysis, we included residents who had an emergency department visit for a fracture (n = 12,927). MEASUREMENTS: Dementia was classified as no, mild, moderate, and severe based on the first MDS assessment each year. In the 120 days of nursing home stay, opioid use was measured as any, prolonged (>90 days), and high-dose (≥90 morphine milligram equivalent dose/day). For residents with a fracture, opioid use was measured within 7 days after emergency department discharge. Association of dementia severity with opioid use was evaluated using logistic regression.
resultsOverall, any opioid use declined by 8.5% (35.2% to 32.2%, P < .001), prolonged use by 5.0% (14.1% to 13.4%, P < .001), and high-dose by 21.4% (1.4% to 1.1%, P < .001) from 2011 to 2017. Opioid use declined across 4 dementia severity groups. Among residents with fracture, opioid use declined by 9% in mild, 9.5% in moderate, and 12.3% in severe dementia. The odds of receiving any, prolonged, and high-dose opioids decreased with increasing severity of dementia. For example, severe dementia reduced the odds of any [23.5% vs 47.6%; odds ratio (OR) 0.56, 95% confidence interval (CI) 0.55-0.57], prolonged (9.8% vs 20.7%; OR 0.69, 95% CI 0.67-0.71), and high-dose (1.0% vs 2.3%; OR 0.69, 95% CI 0.63-0.74) opioids. CONCLUSIONS AND IMPLICATIONS: Use of opioids declined in nursing home residents from 2011 to 2017, and the use was lower in residents with dementia, possibly reflecting suboptimal pain management in this population.
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