title: Clinical and demographic covariates of chronic opioid and non-opioid analgesic use in rural-dwelling older adults: the MoVIES project.
abstract: BACKGROUND
  To describe covariates and patterns of late-life analgesic use in the rural, population-based MoVIES cohort from 1989 to 2002.
  
  
  METHODS
  Secondary analysis of epidemiologic survey of elderly people conducted over six biennial assessment waves. Potential covariates of analgesic use included age, gender, depression, sleep, arthritis, smoking, alcohol, and general health status. Of the original cohort of 1,681, this sample comprised 1,109 individuals with complete data on all assessments. Using trajectory analysis, participants were characterized as chronic or non-chronic users of opioid and non-opioid analgesics. Multivariable regression was used to model predictors of chronic analgesic use.
  
  
  RESULTS
  The cohort was followed for mean (SD) 7.3 (2.7) years. Chronic use of opioid analgesics was reported by 7.2%, while non-opioid use was reported by 46.1%. In the multivariable model, predictors of chronic use of both opioid and non-opioid analgesics included female sex, taking ≥2 prescription medications, and "arthritis" diagnoses. Chronic opioid use was also associated with age 75-84 years; chronic non-opioid use was also associated with sleep continuity disturbance.
  
  
  CONCLUSIONS
  These epidemiological data confirm clinical observations and generate hypotheses for further testing. Future studies should investigate whether addressing sleep problems might lead to decreased use of non-opioid analgesics and possibly enhanced pain management.
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Jordan F
authors.initials: JF
authors.lastname: Karp
authors.forename: Ching-Wen
authors.initials: CW
authors.lastname: Lee
authors.forename: Jonathan
authors.initials: J
authors.lastname: McGovern
authors.forename: Gary
authors.initials: G
authors.lastname: Stoehr
authors.forename: Chung-Chou H
authors.initials: CC
authors.lastname: Chang
authors.forename: Mary
authors.initials: M
authors.lastname: Ganguli
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D001168:Arthritis / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000188:drug therapy; D059408:Pain Management / Q000706:statistics & numerical data; D010414:Pennsylvania / Q000453:epidemiology; D011446:Prospective Studies; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D012893:Sleep Wake Disorders / Q000188:drug therapy
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid