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Factors Influencing Trends in Opioid Prescribing for Older People: A Scoping Review

Mikelyte, Rasa, Abrahamson, V., Hill, Emma, Wilson, Patricia M. (2020) Factors Influencing Trends in Opioid Prescribing for Older People: A Scoping Review. Primary Health Care Research & Development, 21 . Article Number 36. ISSN 1463-4236. (doi:10.1017/S1463423620000365) (KAR id:82317)

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Abstract

Aim: The review aimed to identify factors influencing opioid prescribing as regular pain-management medication for older people. Background: Chronic pain occurs in 45–85% of older people but appears to be under-recognised and undertreated. However, strong opiate prescribing is more prevalent in older people, increasing at the fastest rate in this age group. Method: This review included all study types, published 1990-2017, which focused on opioid prescribing for pain-management among older adults. Arksey and O’Malley’s (2005) framework was used to scope the literature. PubMed, EBSCO Host, the UK Drug Database and Google Scholar were searched. Data extraction, carried out by two researchers, included factors explaining opioid prescribing patterns and prescribing trends. Findings: 613 papers were identified and 53 were included in the final review consisting of 35 research papers, 10 opinion pieces and 8 grey literature sources. Factors associated with prescribing patterns were categorised according to whether they were patient-related, prescriber-driven or system driven. Patient factors included age, gender, race and cognition; prescriber factors included attitudes towards opioids and judgements about ‘normal’ pain; and policy/system factors related to the changing policy landscape over the last three decades, particularly in the USA. Conclusion: A large number of context-dependent factors appeared to influence opioid prescribing for chronic pain-management in older adults but the findings were inconsistent. There is a gap in the literature relating to the UK healthcare system; the prescriber and the patient perspective; and within the context of multi-morbidity and treatment burden.

Item Type: Article
DOI/Identification number: 10.1017/S1463423620000365
Uncontrolled keywords: opioids, prescribing, pain management, older people
Subjects: R Medicine
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research
Depositing User: Vanessa Abrahamson
Date Deposited: 31 Jul 2020 09:01 UTC
Last Modified: 24 Sep 2020 09:03 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/82317 (The current URI for this page, for reference purposes)
Mikelyte, Rasa: https://orcid.org/0000-0002-2772-8240
Abrahamson, V.: https://orcid.org/0000-0002-1169-9457
Wilson, Patricia M.: https://orcid.org/0000-0002-5787-9736
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