Article
Anesthesiology
Nafisseh S. Warner, Michelle Mielke, Brandon P. Verdoorn, David S. Knopman, William M. Hooten, Elizabeth B. Habermann, David O. Warner
Summary: This manuscript summarizes the evidence and critical knowledge gaps regarding the relationships between pain, opioid analgesics, and cognition in older adults. It provides a conceptual framework to guide future research in optimizing analgesic outcomes in older adults while minimizing deleterious effects on cognition.
Article
Geriatrics & Gerontology
Yinan Huang, Rajender R. Aparasu, Tyler J. Varisco
Summary: This study aimed to examine the prescribing practices of opioids for pain management in older adults with and without Alzheimer's Disease and Related Dementias (ADRD). The study found that around 27.19% of older adults received opioid prescriptions for pain, with 30% of them also being prescribed sedatives. ADRD was not found to be associated with opioid prescribing or co-prescribing of opioids and sedatives.
Article
Oncology
Laura Van Metre Baum, K. C. Madhav, Pamela R. Soulos, Molly M. Jeffery, Kathryn J. Ruddy, Catherine C. Lerro, Hana Lee, David J. Graham, Donna R. Rivera, Michael S. Leapman, Vikram Jairam, Michaela A. Dinan, Cary P. Gross, Henry S. Park
Summary: Our study found that new opioid use was higher in patients with cancer compared to those without cancer. From 2012 to 2017, the predicted probability of new opioid use remained relatively stable in patients with cancer, while there was a greater decline in non-cancer patients. Early additional opioid use declined among surgery patients, but was stable among patients with metastatic disease.
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE
(2023)
Article
Geriatrics & Gerontology
Kebede Beyene, Hoda Fahmy, Amy Hai Yan Chan, Andrew Tomlin, Gary Cheung
Summary: This retrospective cohort study in New Zealand aimed to determine the incidence and predictors of long-term or persistent opioid use (POU) in opioid-naive older adults without a cancer diagnosis. The study found that the use of fentanyl, slow-release opioids, and strong opioids, as well as comorbidities, history of substance abuse, living in socioeconomically deprived areas, and the use of certain medications, were the strongest predictors of POU.
Article
Health Care Sciences & Services
Adrienne H. Sabety, Tisamarie B. Sherry, Nicole Maestas
Summary: The introduction of Medicare Part D did not lead to increased opioid use among older adults, but rather the high levels of opioid use among commercially insured adults who aged into Medicare had a greater impact. Therefore, more judicious prescribing to younger adults and efforts to deprescribe opioids when appropriate may prevent problematic opioid use among the elderly.
HEALTH SERVICES RESEARCH
(2021)
Article
Geriatrics & Gerontology
Gillian Fennell, Mireille Jacobson, Hanna Grol-Prokopczyk
Summary: Background: Long-term opioid therapy (L-TOT) is common among older adults with chronic pain, but there is limited understanding of the predictors for such therapy in this population. This study aimed to identify predictors of L-TOT using data from the Health and Retirement Study.
Methods: A multinomial logistic regression was conducted using 5 waves of data from the study, with participants aged 51 and older categorized into nonusers, single-wave users, and multiwave users of opioids. Various demographic, socioeconomic, geographic, health, and healthcare-related factors were included in the model.
Results: The results showed that both single-wave users and multiwave users were more likely to be younger, have lower household wealth, live in certain regions of the U.S., and have certain types of pain. Additionally, multiwave users were less likely to be Black or Hispanic, and less likely to be never married.
Discussion and Implications: This study identified several predictors of long-term opioid use among older adults, including demographic, socioeconomic, geographic, and healthcare-related factors. The findings highlight the need for policy-makers and researchers to pay attention to regional differences in opioid use and the frequency of doctor visits. Recommendations based on a sensitivity analysis of more recent data were also provided.
INNOVATION IN AGING
(2023)
Article
Medicine, General & Internal
J. Deanna Wilson, Kaleab Z. Abebe, Kevin Kraemer, Jane Liebschutz, Jessica Merlin, Elizabeth Miller, David Kelley, Julie Donohue
Summary: This study identified two trajectories of opioid prescribing patterns in opioid-naive youths, with high-risk trajectory associated with older age and longer, more potent initial prescriptions. Even short and low-dose opioid prescriptions can be associated with risks of persistent opioid use for youths.
Article
Health Care Sciences & Services
Monika Salkar, Sujith Ramachandran, John P. Bentley, Ike Eriator, Gerald McGwin, Channing C. Twyner, Yi Yang
Summary: This study evaluated the relationship between opioid dose and formulation and the risk of opioid-related adverse events among Medicare-eligible older adults on long-term opioid therapy. Findings revealed that older adults receiving medically prescribed opioids at higher doses and those using long-acting and combination opioids are at increased risks for opioid-related adverse events, highlighting the importance of close patient supervision.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2022)
Article
Medicine, General & Internal
David R. Axon, Megan Grieser
Summary: This study investigates the variables associated with multimorbidity status among older US adults with self-reported pain and opioid use. The study finds that individuals aged 50-64, Hispanic, employed, and those who exercise frequently have lower odds of having multimorbidity.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Orthopedics
Kanu Okike, Richard N. Chang, Priscilla H. Chan, Elizabeth W. Paxton, Heather A. Prentice
Summary: This study investigated prolonged opioid usage after hip fracture in older individuals and found that the risk factors included younger age, female gender, smoking history, fracture fixation, and anxiety. Prolonged usage was less common among Asian patients and those with a history of dementia.
JOURNAL OF ARTHROPLASTY
(2023)
Article
Geriatrics & Gerontology
Tyler Bell, Carol E. Franz, William S. Kremen
Summary: This study found that the presence of persistent pain is associated with an increased risk of cognitive impairment, especially when it involves interference with daily tasks such as work and chores. The ongoing interference of pain can affect cognitive performance and may lead to cognitive impairment. Pain management may be crucial in helping to maintain cognition in old age and reduce the risk of dementia.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2022)
Article
Medicine, General & Internal
Faroakh Hosseini, Sophie Mullins, William Gibson, Miriam Thake
Summary: Physiological changes in older adults can affect how acute pain is perceived, diagnosed, and managed. Understanding these differences is crucial for identifying, assessing, and treating acute pain in this population. Careful selection of pain medications and proper titration and monitoring can help meet the analgesic needs of older adults.
Article
Public, Environmental & Occupational Health
Shishir Maharjan, Sujith Ramachandran, Kaustuv Bhattacharya, John P. Bentley, Ike Eriator, Yi Yang
Summary: This study examines the relationship between opioid tapering velocity and mental health crisis events in older Medicare beneficiaries. The results show that both tapering and dose escalation are associated with mental health crisis events. Therefore, patient-driven and gradual dose tapering, as recommended by prescribing guidelines, should be promoted to prevent these events among older adults on long-term opioid therapy.
PHARMACOEPIDEMIOLOGY AND DRUG SAFETY
(2023)
Article
Medicine, Research & Experimental
Ainur Kagarmanova, Heather Sparkman, Neda Laiteerapong, Katherine Thompson, Linda Rosul, Danielle Lazar, Erin Staab, Wen Wan, Amanda Kass, Mim Ari
Summary: This study protocol describes the planned implementation and evaluation of I-COPE, a program aimed at improving care for older adults with chronic pain, opioid use, and opioid use disorder. By integrating patient-reported data, clinical decision support tools, and a shared decision-making tool into routine primary care, the program aims to enhance the management of chronic pain, opioid prescribing, and opioid use disorder. The study will assess the outcomes 6 and 12 months after implementation.
Article
Pediatrics
Kao-Ping Chua, Chad M. Brummett, Rena M. Conti, Amy S. Bohnert
Summary: In 2019, 3.5% of US children and young adults had >= 1 dispensed opioid prescription, with nearly half being high risk prescriptions. The high-volume prescribers accounted for a large portion of high-risk prescriptions and targeted interventions may be needed to address this issue.
Review
Endocrinology & Metabolism
Maria Papaleontiou, Megan R. Haymart
BEST PRACTICE & RESEARCH CLINICAL ENDOCRINOLOGY & METABOLISM
(2020)
Article
Oncology
Maria Papaleontiou, Bradley Zebrack, David Reyes-Gastelum, Andrew J. Rosko, Sarah T. Hawley, Ann S. Hamilton, Kevin C. Ward, Megan R. Haymart
Summary: Physicians in this study found that many thyroid cancer patients experience worry at diagnosis, and when dealing with worried patients, physicians typically provide various forms of help and advice, although the actual effectiveness of some approaches remains unclear. Therefore, efforts are needed to develop tailored interventions targeting survivors' psychosocial needs.
JOURNAL OF CANCER SURVIVORSHIP
(2021)
Review
Endocrinology & Metabolism
Naykky Singh Ospina, Maria Papaleontiou
Summary: The prevalence of thyroid nodules increases with age, with identified cancers in older adults more likely to be of high-risk histology. The goals and tools for thyroid nodule evaluation are similar for older and younger patients, but limited evidence exists for personalized decision making in the geriatric population.
ENDOCRINE PRACTICE
(2021)
Article
Endocrinology & Metabolism
Maria Papaleontiou, Edward C. Norton, David Reyes-Gastelum, Mousumi Banerjee, Megan R. Haymart
Summary: This study aimed to investigate the likelihood of older adults with thyroid cancer dying from either the cancer itself or other causes, and identified factors associated with each outcome. The results showed that differentiated thyroid cancer patients are more likely to die from other causes, while anaplastic thyroid cancer patients are more likely to die from the cancer itself. The study also found associations between patient demographics and comorbidities with death from other causes, and tumor characteristics with death from thyroid cancer.
Article
Endocrinology & Metabolism
Maria Papaleontiou, Debbie W. Chen, Mousumi Banerjee, David Reyes-Gastelum, Ann S. Hamilton, Kevin C. Ward, Megan R. Haymart
Summary: The study revealed that many low-risk thyroid cancer patients continue to be treated with suppressive doses of thyroid hormone, highlighting the need for more high-quality research to guide thyroid cancer management, as well as better understanding of barriers that hinder guideline adoption.
Article
Endocrinology & Metabolism
Maria Papaleontiou, Deborah A. Levine, David Reyes-Gastelum, Sarah T. Hawley, Mousumi Banerjee, Megan R. Haymart
Summary: The study aimed to determine the association between thyroid hormone treatment intensity and the incidence of atrial fibrillation and stroke. Results indicated that both exogenous hyper- and hypothyroidism were associated with an increased risk of stroke, while hypothyroidism was linked to a higher risk of atrial fibrillation.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2021)
Article
Health Care Sciences & Services
Anurag Ratan Goel, Charles R. Henderson, Manney Carrington Reid
Summary: This is a nationwide survey that investigates the recommendation behaviors of complementary and integrative medicine (CIM) by healthcare providers in palliative care. The results show that healthcare providers recommend a wide range of CIM therapies, but at a lower frequency than what patients report.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
(2022)
Article
Anesthesiology
Clara Scher, Charles R. Henderson, Karl Pillemer, Patricia Kim, M. Carrington Reid
Summary: In this study, the importance of seven pain treatment goals among older adults was examined. The results showed that minimizing harmful side effects of pain medications was ranked as the least important goal, while finding a cure and reducing pain were ranked as the most important goals. There were no gender or race/ethnicity differences in the importance of these goals. Age was negatively associated with the goals of minimizing side effects and decreasing pain's effects on everyday activities. Pain reduction was rated as more important than all other goals except finding a cure.
Article
Health Care Sciences & Services
Daniel Shalev, Melissa Patterson, Yasemin Aytaman, Manuel A. Moya-Tapia, Craig D. Blinderman, Milagros D. Silva, M. Carrington Reid
Summary: This study aimed to implement operationalized depression screening using the Patient Health Questionnaire-2 (PHQ-2) in non-surgical palliative care. The results showed an increase in the execution rate of depression screening from 2% to 38%. All clinicians perceived the incorporation of depression screening as useful and feasible, suggesting completion of screening prior to clinician visit to improve uptake.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
(2023)
Review
Health Care Sciences & Services
Karolina Sadowska, Tina Fong, Daniel R. Horning, Sandra McAteer, Maureen I. Ekwebelem, Michelle Demetres, M. Carrington Reid, Daniel Shalev
Summary: This literature review examined the association between psychiatric comorbidities and outcomes in palliative and end-of-life care. Psychiatric comorbidity was found to be associated with poor quality of life, increased physical symptom burden, and low function. Additionally, it was found to increase utilization of palliative care services. The integration of mental health and palliative care services may enhance quality-of-life among patients at end of life.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
(2023)
Article
Health Care Sciences & Services
Daniel Shalev, Maureen I. Ekwebelem, Lilla A. Brody, Mary E. Callahan, Navendra Singh, M. Carrington Reid
Summary: There is variability in clinical and didactic exposure to mental health training among Hospice and Palliative Medicine (HPM) fellowships, resulting in uncertainty and different levels of preparedness for dealing with psychological and psychiatric aspects of palliative care.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
(2023)
Article
Rheumatology
Sarah B. Lieber, Musarrat Nahid, Alexandra Legge, Mangala Rajan, Robyn A. Lipschultz, Myriam Lin, M. Carrington Reid, Lisa A. Mandl
Summary: This study compared the application of two different methods of measuring frailty in women with SLE and found that 17.9-26.9% of patients were frail. Frail patients had worse disease damage and disability compared to non-frail patients. After adjusting for age, frailty was associated with a greater odds of disability.
Article
Gerontology
Shelbie G. Turner, Jamaica R. M. Robinson, Karl A. Pillemer, M. Carrington Reid
Summary: This study analyzed national survey data to assess the prevalence of physical pain among family caregivers to older adults. The results showed that arthritis and activity-limiting bothersome pain are highly prevalent among caregivers. Older age and higher education levels were associated with a higher prevalence of arthritis. Black caregivers had a lower prevalence of arthritis and activity-limiting bothersome pain compared to White caregivers. Caregivers with physical difficulty providing care had a higher prevalence of arthritis and activity-limiting bothersome pain.
Article
Geriatrics & Gerontology
Anthony D. Ong, Kenneth Tyler Wilcox, Judith T. Moskowitz, Elaine Wethington, Elizabeth L. Addington, Mubarak O. Sanni, Patricia Kim, M. Cary Reid
Summary: This study examined the feasibility, acceptability, and preliminary efficacy of a positive affect skills intervention for middle-aged and older adults with fibromyalgia syndrome (FMS). The results showed high completion rates and satisfaction ratings among participants. Those who received the intervention had significantly greater improvements in positive affect, negative affect, and pain catastrophizing compared to the control group. These improvements were maintained at 1-month follow-up. The level of intervention engagement predicted reductions in pain catastrophizing.
INNOVATION IN AGING
(2023)
Article
Geriatrics & Gerontology
Catherine Riffin, Lilla Brody, Priya Mukhi, Keela Herr, Karl Pillemer, Madeline Rogers, Charles R. Henderson Jr, M. Cary Reid
Summary: Despite the prevalence of pain in persons with dementia, it is often underdetected and undermanaged. This study evaluates a multicomponent intervention called the Pain Identification and Communication Toolkit (PICT) which provides training in observational pain assessment and coaching in pain communication techniques for family caregivers. The results show that PICT is feasible to implement, acceptable to caregivers, and has the potential to improve confidence in recognizing and communicating about pain.
INNOVATION IN AGING
(2023)