National study of injury-increasing analgesics in the elderly

Purpose - The purpose of this paper is to identify the probability of the occurrence of an analgesic medication injury when controlling for potential risk factors, as well as gain a better understanding of which risk factors appear more problematic.Design methodology approach - Cross-sectional retrospective review of 2004 Centers for Medicare and Medicaid Service Medicaid Pharmacy claims data. Logistic regression analysis performed to examine the risk of injury-related emergency room (ER) visits following the use of analgesics controlling for potential risk factors.Findings - Methadone, an agent to treat severe pain, and propoxyphene, an agent to treat non-severe pain, are problematic opioids in the elderly. White origin, male gender, and increased disease burden are potential risk factors influencing injury-related ER visits for elderly analgesic recipients. Increased age in the elderly is a potential risk factor for severe pain analgesics; decreased age for non-severe pain analgesics.Research limitations implications - The study uses administrative data which, by its nature, makes conducting outcomes research on inappropriate medication use problematic. A number of confounders are present.Practical implications - Appropriate drug therapy in an elderly patient is complicated by age-related changes in pharmacokinetics as well as chronic disorders that affect drug response. Knowing of additional risk factors that may place the patient at greater odds of having an adverse outcome should improve prescribing practices.Originality value - The findings add to the literature by identifying problematic risk factors associated with injury among elderly recipients of analgesics.