Relationship Between Self-Reported Mental Health and Characteristics of US Adults Age ≥50 Years with Self-Reported Pain and Documented Opioid Treatment

OBJECTIVES: Studies have demonstrated associations between pain, mental health, and opioids. However, the characteristics associated with mental health among older United States (US) adults with pain who used an opioid is poorly understood. This study used a nationally representative dataset to investigate the association between self-reported mental health and various characteristics among US adults (≥50 years of age) with self-reported pain in the past four weeks who also used an opioid in the calendar year.

METHODS: This retrospective, cross-sectional database study utilized 2020 Medical Expenditure Panel Survey (MEPS) data. Eligible subjects were alive, aged ≥50 years, reported having pain within the past four weeks, and were prescribed ≥1 opioid within the calendar year. Analysis was weighted to obtain nationally representative estimates. Chi-square tests were used to compare good versus poor mental health. A multivariable logistic regression model assessed associations of good versus poor mental health. The a priori alpha=0.05

RESULTS: A total of 866 participants met the study eligibility criteria, of which 668 reported good mental health, while 176 reported poor mental health. This translated to a weighted population of 10,602,045 individuals, of which 80% (95% confidence interval (CI)=76.7%-83.4%) reported good mental health, while 20% (95% CI=16.6%-23.3%) reported poor mental health. There were statistically significant differences (p<0.05) between groups for education, employment, income, health insurance, physical health, exercise, smoking, limitation, and pain severity. The logistic regression showed physical health (adjusted odds ratio (AOR)=11.2; 95% CI=6.9-18.2) had the strongest association with mental health. Employment status (AOR=2.7; 95% CI=1.2-6.0) also had a statistically significant association with mental health

CONCLUSIONS: This study found perceived physical health and employment were associated with mental health in older adults with pain who received an opioid. These findings offer important insights for clinicians and policymakers to consider when formulating approaches to better manage the mental health of these class of patients.