title: Side effects from oral opioids in older adults during the first week of treatment for acute musculoskeletal pain.
abstract: OBJECTIVE
  The authors sought to describe the frequency of short-term side effects experienced by older adults initiating treatment with opioid-containing analgesics for acute musculoskeletal pain.
  
  
  METHODS
  This was a cross-sectional study of individuals age 65 years or older initiating analgesic treatment following emergency department (ED) visits for acute musculoskeletal pain. Patients were called by phone 4 to 7 days after their ED visits to assess the intensity of six common opioid-related side effects using a 0 to 10 scale and to assess medication discontinuation due to side effects. Propensity score matching was used to compare side effects among patients initiating treatment with any opioid-containing analgesics to side effects among those initiating treatment with only nonopioids.
  
  
  RESULTS
  Of 104 older patients initiating analgesic treatment following ED visits for musculoskeletal pain, 71 patients took opioid-containing analgesics, 15 took acetaminophen, and 18 took ibuprofen. Among the patients who took opioids, at least one side effect of moderate or severe intensity (score ≥ 4) was reported by 62%. Among patients with matching propensity scores, those taking opioids were more likely to have had moderate or severe side effects than those taking only nonopioids (62%, 95% confidence interval [CI] = 48% to 74% vs. 4%, 95% CI = 1% to 20%) and were also more likely to have discontinued treatment due to side effects (16%, 95% CI = 8% to 29% vs. 0%, 95% CI = 0% to 13%). The most common side effects due to opioids were tiredness, nausea, and constipation.
  
  
  CONCLUSIONS
  Among older adults initiating treatment with opioid-containing analgesics for musculoskeletal pain, side effects were common and sometimes resulted in medication discontinuation.
authors.affiliation: Department of Biostatistics, University of North Carolina Chapel Hill, Chapel Hill, NC.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Hunold
authors.forename: Denise A
authors.initials: DA
authors.lastname: Esserman
authors.forename: Cameron G
authors.initials: CG
authors.lastname: Isaacs
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Dickey
authors.forename: Greg F
authors.initials: GF
authors.lastname: Pereira
authors.forename: Roger B
authors.initials: RB
authors.lastname: Fillingim
authors.forename: Philip D
authors.initials: PD
authors.lastname: Sloane
authors.forename: Samuel A
authors.initials: SA
authors.lastname: McLean
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Platts-Mills
mesh_terms: D000082:Acetaminophen / Q000009:adverse effects / Q000627:therapeutic use; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000188:drug therapy*; D009657:North Carolina; D010147:Pain Measurement; D057216:Propensity Score; D016896:Treatment Outcome
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000082:Acetaminophen; D007052:Ibuprofen
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