Hunnicutt JN, et al. - This study was performed to investigate the prevalence of long-term opioid use in long-stay nursing home residents. The authors found that 1/7 nursing home (NH) residents were prescribed opioids long-term. For pain, recent guidelines on opioid prescribing recommended reducing long-term opioid use, but this was challenging in NHs because residents could not benefit from nonpharmacological and nonopioid interventions. They recommended further studies to address concerns about opioid safety and effectiveness (e.g., on pain and functional status) in NHs.

• The authors performed a cross-sectional study in U.S. NHs (N = 13,522).
• Between April 1, 2012, and June 30, 2012, they selected long-stay NH resident Medicare beneficiaries with a Minimum Data Set 3.0 (MDS) assessment and 120 days of follow-up (N = 315,949).
• Medicare Part D claims were used to measure length of opioid use in the 120 days from the index assessment (short-term: ≤30 days, medium-term: >30-89 days, long-term: ≥90 days), adjuvants (e.g., anticonvulsants), and other pain medications (e.g., corticosteroids).
• To measure nonpharmacological pain management use, MDS assessments in the follow-up period were used.
• They used modified Poisson models to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) for age, gender, race and ethnicity, cognitive and physical impairment, and long-term opioid use.

• 32.4% were prescribed any opioid, and 15.5% were prescribed opioids long-term, among all long-stay residents.
• Compared to nonusers, opioid users were more commonly prescribed pain adjuvants (32.9% vs 14.9%), other pain medications (25.5% vs 11.0%), and nonpharmacological pain management (24.5% vs 9.3%).
• In women, long-term opioid use was higher (aPR = 1.21, 95% CI = 1.18–1.23) and lower in racial and ethnic minorities (non-Hispanic blacks vs whites: APR = 0.93, 95% CI = 0.90–0.94) and those with severe cognitive impairment (vs no or mild impairment, aPR = 0.82, 95% CI = 0.79–0.83).