Impact of opioid initiation on antipsychotic and benzodiazepine and - - PowerPoint PPT Presentation

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Impact of opioid initiation on antipsychotic and benzodiazepine and - - PowerPoint PPT Presentation

Nov 22, 2022 113 likes •265 views

Impact of opioid initiation on antipsychotic and benzodiazepine and related drug (BZDR) use among persons with Alzheimers disease an interrupted time series analysis Aleksi Hamina, MSc (Pharm) Kuopio Research Center for Geriatric Care No

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Aleksi Hamina, MSc (Pharm)

Impact of opioid initiation on antipsychotic and benzodiazepine and related drug (BZDR) use among persons with Alzheimer’s disease –an interrupted time series analysis

Kuopio Research Center for Geriatric Care

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UEF // University of Eastern Finland

No conflicts of interest to report

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UEF // University of Eastern Finland

Neuropsychiatric symptoms in AD are common

Koponen et al. BJP 2015;207:444-449

– so is symptomatic pharmacotherapy

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UEF // University of Eastern Finland

Does treating pain decrease neuropsychiatric symptoms?

  • Yeah, maybe

– Mixed, but overall positive results

Manfredi et al. Int J Geriatr Psychiatry. 2003 Aug;18(8):700-5. Husebo et al. BMJ. 2011 Jul 15;343:d4065 Chibnall et al. J Am Geriatr Soc. 2005 Nov;53(11):1921-9. Husebo et al. Am J Geriatr Psychiatry. 2014 Jul;22(7):708-17. Husebo et al. Int J Geriatr Psychiatry. 2014 Aug;29(8):828-36.

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UEF // University of Eastern Finland

Does opioid initiation impact the use of antipsychotics and BZDRs?

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UEF // University of Eastern Finland

70,718 community-dwelling persons with AD (2005-2011) Opioid initiators in 2010-2011 Nationwide Prescription Register Hospital Discharge Register Matched cohort of non-initiators

Tolppanen et al BMJ Open. 2016 Jul 13;6(7):e012100

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UEF // University of Eastern Finland

Nationwide Prescription Register

  • No over-the-counter (OTC) medicines
  • Only Reimbursed medicines

Hospital Discharge Register

  • No medicines during hospitalization
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UEF // University of Eastern Finland

Methods

OUTCOME (DRUG USE PREVALENCE) TIME Change in level

  • 30
  • 60
  • 90
  • 120
  • 150

30 60 90 120 150 180

  • 180

Opioid initiation

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UEF // University of Eastern Finland

Results - Study population

  • 3,327 opioid initiators
  • 3,325 non-initiators
  • Mean age 82.2 (SD 6.9 years)
  • 68% were women
  • All studied comorbidities were more common among opioid initiators

– Eg. prevalence of cancer 8.5% vs. 4.9%

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UEF // University of Eastern Finland

Opioid initiators Non-initiators

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UEF // University of Eastern Finland

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UEF // University of Eastern Finland

Discussion and conclusions

  • Antipsychotic and BZDR use was frequent.
  • Opioid initiation resulted in an initial surge – and an overall decrease.
  • Decrease in neuropsychiatric symptoms or intentional reduction of

sedative load? aleksi.hamina@uef.fi

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UEF // University of Eastern Finland

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UEF // University of Eastern Finland

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UEF // University of Eastern Finland