Pain Management in Older Adults Before and During the First Year of COVID-19 Pandemic: Prevalence, Trends, and Correlates.
Chronic pain
Coronavirus disease of 2019
High impact chronic pain
Older adults
Opioids
Journal
The journals of gerontology. Series A, Biological sciences and medical sciences
ISSN: 1758-535X
Titre abrégé: J Gerontol A Biol Sci Med Sci
Pays: United States
ID NLM: 9502837
Informations de publication
Date de publication:
27 08 2023
27 08 2023
Historique:
received:
05
03
2023
pmc-release:
25
04
2024
medline:
29
8
2023
pubmed:
25
4
2023
entrez:
25
04
2023
Statut:
ppublish
Résumé
There is limited knowledge on whether and how health care access restrictions imposed by the coronavirus disease of 2019 pandemic have affected utilization of both opioid and nonpharmacological treatments among US older adults living with chronic pain. We compared prevalence of chronic pain and high impact chronic pain (ie, chronic pain limiting life or work activities on most days or every day in the past 6 months) between 2019 (pre-pandemic) and 2020 (first year of pandemic) and utilization of opioids and nonpharmacological pain treatments among adults aged ≥65 years enrolled in the National Health Interview Survey, a nationally representative sample of noninstitutionalized civilian U.S. adults. Of 12 027 survey participants aged ≥65 (representing 32.6 million noninstitutionalized older adults nationally), the prevalence of chronic pain was not significantly different from 2019 (30.8%; 95% confidence interval [CI], 29.7%-32.0%) to 2020 (32.1%; 95% CI, 31.0%-33.3%; p = .06). Among older adults with chronic pain, the prevalence of high impact chronic pain was also unchanged (38.3%; 95% CI, 36.1%-40.6% in 2019 versus 37.8%; 95% CI, 34.9%-40.8% in 2020; p = .79). Use of any nonpharmacological interventions for pain management decreased significantly from 61.2% (95 CI, 58.8%-63.5%) in 2019 to 42.1% (95% CI, 40.5%-43.8%) in 2020 (p < .001) among those with chronic pain, as did opioid use in the past 12 months from 20.2% (95% CI, 18.9%-21.6%) in 2019 to 17.9% (95% CI, 16.7%-19.1%) in 2020 (p = .006). Predictors of treatment utilization were similar in both chronic pain and high-impact chronic pain. Use of pain treatments among older adults with chronic pain declined in the first year of coronavirus disease of 2019 pandemic. Future research is needed to assess long-term effects of coronavirus disease of 2019 pandemic on pain management in older adults.
Sections du résumé
BACKGROUND
There is limited knowledge on whether and how health care access restrictions imposed by the coronavirus disease of 2019 pandemic have affected utilization of both opioid and nonpharmacological treatments among US older adults living with chronic pain.
METHODS
We compared prevalence of chronic pain and high impact chronic pain (ie, chronic pain limiting life or work activities on most days or every day in the past 6 months) between 2019 (pre-pandemic) and 2020 (first year of pandemic) and utilization of opioids and nonpharmacological pain treatments among adults aged ≥65 years enrolled in the National Health Interview Survey, a nationally representative sample of noninstitutionalized civilian U.S. adults.
RESULTS
Of 12 027 survey participants aged ≥65 (representing 32.6 million noninstitutionalized older adults nationally), the prevalence of chronic pain was not significantly different from 2019 (30.8%; 95% confidence interval [CI], 29.7%-32.0%) to 2020 (32.1%; 95% CI, 31.0%-33.3%; p = .06). Among older adults with chronic pain, the prevalence of high impact chronic pain was also unchanged (38.3%; 95% CI, 36.1%-40.6% in 2019 versus 37.8%; 95% CI, 34.9%-40.8% in 2020; p = .79). Use of any nonpharmacological interventions for pain management decreased significantly from 61.2% (95 CI, 58.8%-63.5%) in 2019 to 42.1% (95% CI, 40.5%-43.8%) in 2020 (p < .001) among those with chronic pain, as did opioid use in the past 12 months from 20.2% (95% CI, 18.9%-21.6%) in 2019 to 17.9% (95% CI, 16.7%-19.1%) in 2020 (p = .006). Predictors of treatment utilization were similar in both chronic pain and high-impact chronic pain.
CONCLUSION
Use of pain treatments among older adults with chronic pain declined in the first year of coronavirus disease of 2019 pandemic. Future research is needed to assess long-term effects of coronavirus disease of 2019 pandemic on pain management in older adults.
Identifiants
pubmed: 37096328
pii: 7140516
doi: 10.1093/gerona/glad115
pmc: PMC10460550
doi:
Substances chimiques
Analgesics, Opioid
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1627-1640Subventions
Organisme : NIA NIH HHS
ID : R21 AG070666
Pays : United States
Informations de copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Références
J Gerontol A Biol Sci Med Sci. 2019 Nov 13;74(12):1910-1915
pubmed: 30561526
Spine (Phila Pa 1976). 2004 Jul 15;29(14):1561-6
pubmed: 15247579
Orthop Nurs. 2019 Nov/Dec;38(6):381-389
pubmed: 31764903
Pain Med. 2015 Dec;16(12):2222-5
pubmed: 26052869
J Gerontol A Biol Sci Med Sci. 2018 Jul 9;73(8):1119-1124
pubmed: 29718133
J Am Board Fam Med. 2021 Feb;34(Suppl):S77-S84
pubmed: 33622822
JAMA Netw Open. 2022 Feb 1;5(2):e2146697
pubmed: 35129599
Pain Physician. 2022 Mar;25(2):131-144
pubmed: 35322967
JAMA Oncol. 2019 Aug 1;5(8):1224-1226
pubmed: 31219506
Psychiatr Serv. 2019 Nov 1;70(11):992-999
pubmed: 31357922
Eur Spine J. 2022 Jan;31(1):167-175
pubmed: 34729679
Drug Alcohol Depend. 2022 Mar 1;232:109339
pubmed: 35121202
JAMA. 2020 Jul 7;324(1):93-94
pubmed: 32492088
Complement Ther Med. 2016 Feb;24:7-12
pubmed: 26860795
Am J Prev Med. 2021 Mar;60(3):434-437
pubmed: 33199162
Prev Chronic Dis. 2020 Sep 17;17:E106
pubmed: 32945769
Pain Physician. 2021 Mar;24(2):165-173
pubmed: 33740352
JAMA Netw Open. 2021 Dec 1;4(12):e2138453
pubmed: 34889946
Sci Rep. 2022 Apr 19;12(1):6435
pubmed: 35440688
Prev Med. 2021 Apr;145:106440
pubmed: 33516759
JAMA. 2021 Feb 9;325(6):520-521
pubmed: 33560310
J Pain. 2016 Oct;17(10):1068-1080
pubmed: 27377620
Headache. 2017 Jan;57(1):97-108
pubmed: 27885674
J Pain. 2022 Dec;23(12):2144-2154
pubmed: 36096352
Can J Pain. 2022 Sep 1;6(1):142-170
pubmed: 36092247
Anaesthesia. 2022 Sep;77(9):1039-1050
pubmed: 35848380
J Am Geriatr Soc. 2020 Aug;68(8):1731-1738
pubmed: 32227645
J Am Geriatr Soc. 2019 Dec;67(12):2463-2473
pubmed: 31437309
Pain. 2022 Feb 1;163(2):e328-e332
pubmed: 33990113
J Am Geriatr Soc. 2022 Feb;70(2):329-340
pubmed: 34850379
J Clin Psychiatry. 2022 Dec 5;84(1):
pubmed: 36479956
J Osteopath Med. 2021 Mar 29;121(7):625-633
pubmed: 33770828
NCHS Data Brief. 2020 Nov;(390):1-8
pubmed: 33151145
Maturitas. 2016 Jul;89:36-42
pubmed: 27180158
Pain Physician. 2022 Mar;25(2):E185-E191
pubmed: 35322970
MMWR Recomm Rep. 2022 Nov 04;71(3):1-95
pubmed: 36327391
J Prim Care Community Health. 2017 Apr;8(2):43-54
pubmed: 27678243
J Psychiatr Res. 2021 Feb;134:113-120
pubmed: 33383494