Association between Self-Reported Pain Severity and Characteristics of US Adults Age ≥50 Years Who Used Opioids

OBJECTIVES: Pain severity in older adults is influenced by several factors, notably, individual characteristics can point to potential predictors of pain severity and can inform individualized pain management. The purpose of this study was to assess the association between the characteristics of United States (US) adults (≥50 years) who used opioids in the calendar year and their self-reported pain severity using a nationally representative dataset.

METHODS: This retrospective cross-sectional database study used the 2019 Medical Expenditure Panel Survey data to identify US adults who were alive, aged ≥50 years with self-reported pain within the past four weeks, and ≥1 opioid prescription within the calendar year. Multivariate logistic regression models were used to assess associations between various characteristics and self-reported pain severity (quite a bit/extreme vs less/moderate pain). The a priori alpha=0.05. Analyses were weighted to obtain nationally representative estimates.

RESULTS: Participants meeting eligibility criteria were 1077 (low/moderate pain=556, quite a bit/extreme pain=521). The weighted population was 12,109,702 (low/moderate pain=54.8% [95% Confidence Interval (CI)=51.2%-58.4%], quite a bit/extreme pain=45.2% [95% CI=41.6%-48.8%]). In the fully adjusted logistic regression model, greater odds of reporting quite a bit/extreme pain were associated with the following: age 50-64 vs ≥65 (adjusted odds ratio (AOR)=1.76; 95% CI=1.22-2.54), non-Hispanic vs Hispanic (AOR=2.0; 95% CI=1.18-3.39), unemployed vs employed (AOR=2.01; 95% CI=1.33-3.05), no health insurance vs private insurance (AOR=6.80; 95% CI=1.43-32.26), fair/poor vs excellent/very good/good health (AOR=3.10; 95% CI=2.19-4.39), fair/poor vs excellent/very good/good mental health (AOR=2.16; 95% CI=1.39-3.38), non-smoker vs smoker (AOR=1.80; 95% CI=1.19-2.71), and instrumental activity of daily living, yes vs no (AOR=2.27; 95% CI=1.30-3.96).

CONCLUSIONS: This study identified several characteristics that can influence pain severity in US adults ≥50 years who have used an opioid. An understanding of these characteristics may be helpful in transforming the healthcare approaches to prevention, education, and management of pain severity in later life.