Assessing the Association between Pain Burden and Limitations Among Older United States Adults with Pain who Used Opioids

OBJECTIVES:

Pain and limitations are prevalent in the United States (US). Opioids are a pain management strategy that may not always be used appropriately. Research is required to assess the association between pain burden and having a limitation among older US adults with pain who used opioids.

METHODS:

US adults aged ≥50 with pain who used an opioid in the 2020 Medical Expenditure Panel Survey were included in the study. Pain was classified as extreme, quite a bit, moderate, or little. Limitations included activities of daily living, instrumental activities of daily living, functional, work, hearing, and vision limitations. Multivariable logistic regression was used to assess the association between pain burden and having a limitation, adjusting for covariates. An alpha of 0.05 was determined a priori.

RESULTS:

Among the weighted population of 10,602,045 individuals, 71.2% had a limitation while 28.8% did not. The most common types of limitation were functional limitations (56.4%) and work limitations (45.3%). After adjusting for covariates, the logistic regression showed having extreme (odds ratio [OR]= 10.30, 95% confidence interval (95% CI)=3.87-27.40), quite a bit (OR=5.07, 95% CI=2.77-9.30) or moderate (OR=2.49, 95% CI=1.40-4.45) pain was associated with greater odds of having a limitation versus having little pain. Additionally, being unemployed (versus employed; OR=5.26, 95% CI=2.94-9.09), unmarried (versus married; OR=1.92, 95% CI=1.12-3.33), having poor health (versus good health; OR=2.08, 95% CI=1.08-4.17), and residing in the Midwest (versus West; OR= 2.04, 95% CI=1.10-3.80) was associated with greater odds of having a limitation.

CONCLUSIONS:

Older US adult opioid users with extreme, quite bit, or moderate pain had greater odds of having a limitation compared to those with little pain. Other characteristics associated with having a limitation should also be considered when reviewing the healthcare needs of older US adults with pain who used opioids.