TY - JOUR
T1 - Use of strong opioids among community-dwelling persons with and without Alzheimer's disease in Finland
AU - Bell, J. Simon
AU - Laitinen, Marja-Liisa
AU - Lavikainen, Piia
AU - Lönnroos, Eija
AU - Uosukainen, Hanna
AU - Hartikainen, Sirpa
PY - 2011/3
Y1 - 2011/3
N2 - The objective of this study was to investigate the national pattern of strong opioid use among community-dwelling persons with and without Alzheimer's disease (AD) in Finland. All persons (n = 28,093) with a diagnosis of AD in 2005 were identified by the Social Insurance Institution of Finland (SII). For each person with AD, the SII identified a comparison person individually matched in terms of age (±1 year), sex, and region of residence. Records of all reimbursed drug purchases in 2005 were extracted from the Finnish National Prescription Register. Conditional logistic regression was used to calculate unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for reimbursed opioid use. The age of the persons with and without AD ranged from 42 to 101 (mean 80.0) years, with men comprising 32.2% (n = 9048) of persons. The annual prevalence of reimbursed opioid use was 3.0% (n = 273) and 3.8% (n = 727) among men and women with AD, respectively. The use of all reimbursed opioids was lower among persons with AD compared with those without AD (adjusted OR 0.77, 95% CI 0.71 to 0.84). The use of strong opioids (adjusted OR 1.26, 95% CI 1.05 to 1.51) and fentanyl (adjusted OR 1.44, 95% CI 1.13 to 1.83) was higher among persons with AD. Our study did not assess the stage or severity of AD, nor the opioid doses prescribed. However, the results highlight the challenges associated with diagnosing and treating pain in this population, and the importance of balancing the risk of adverse drug reactions against the ease of transdermal administration. Use of opioid analgesics was lower among 28,089 persons with Alzheimer's disease (AD) compared with individually matched comparison persons without AD. However, use of strong opioids and transdermal fentanyl was more prevalent among persons with AD.
AB - The objective of this study was to investigate the national pattern of strong opioid use among community-dwelling persons with and without Alzheimer's disease (AD) in Finland. All persons (n = 28,093) with a diagnosis of AD in 2005 were identified by the Social Insurance Institution of Finland (SII). For each person with AD, the SII identified a comparison person individually matched in terms of age (±1 year), sex, and region of residence. Records of all reimbursed drug purchases in 2005 were extracted from the Finnish National Prescription Register. Conditional logistic regression was used to calculate unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for reimbursed opioid use. The age of the persons with and without AD ranged from 42 to 101 (mean 80.0) years, with men comprising 32.2% (n = 9048) of persons. The annual prevalence of reimbursed opioid use was 3.0% (n = 273) and 3.8% (n = 727) among men and women with AD, respectively. The use of all reimbursed opioids was lower among persons with AD compared with those without AD (adjusted OR 0.77, 95% CI 0.71 to 0.84). The use of strong opioids (adjusted OR 1.26, 95% CI 1.05 to 1.51) and fentanyl (adjusted OR 1.44, 95% CI 1.13 to 1.83) was higher among persons with AD. Our study did not assess the stage or severity of AD, nor the opioid doses prescribed. However, the results highlight the challenges associated with diagnosing and treating pain in this population, and the importance of balancing the risk of adverse drug reactions against the ease of transdermal administration. Use of opioid analgesics was lower among 28,089 persons with Alzheimer's disease (AD) compared with individually matched comparison persons without AD. However, use of strong opioids and transdermal fentanyl was more prevalent among persons with AD.
KW - Alzheimer's disease
KW - Analgesics
KW - Drug utilization
KW - Finland
KW - Pain
UR - http://www.scopus.com/inward/record.url?scp=79851512839&partnerID=8YFLogxK
U2 - 10.1016/j.pain.2010.11.003
DO - 10.1016/j.pain.2010.11.003
M3 - Article
C2 - 21247697
AN - SCOPUS:79851512839
SN - 0304-3959
VL - 152
SP - 543
EP - 547
JO - Pain
JF - Pain
IS - 3
ER -