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A systematic review of opioid prevalence in Australian residential aged care facilities
Dowd, LA and Reynolds, L and Cross, AJ and Veal, F and Steeper, M and Wanas, Z and Wu, N and Bell, JS, A systematic review of opioid prevalence in Australian residential aged care facilities, Australasian Journal on Ageing, 41, (4) pp. 501-512. ISSN 1440-6381 (2022) [Refereed Article]
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© 2022 The Authors. Australasian Journal on Ageing published by John Wiley & Sons Australia, Ltd on behalf of AJA Inc. This is an open access article under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) License, (https://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Objective: To systematically review the prevalence of opioid prescribing, dispensing and administration in Australian residential aged care facilities (RACFs).
Methods: MEDLINE, Embase, CINAHL, AgeLine, Web of Science Core Collection, InformIT and International Pharmaceutical Abstracts (inception to September 2021) were searched for studies reporting opioid prevalence in Australian RACFs. Regular and as-required (i.e. pro re nata, PRN) opioid uses were considered. Screening, data extraction and quality assessment were performed independently by two review authors.
Results: Twenty-three studies (n = 286,141 residents) reported opioid prevalence, of which 16 provided overall regular or PRN prescribing, dispensing or administration data. Five studies reported 28%-34% of residents were prescribed regular opioids over assessment periods ranging from one week to one month. Five studies reported 11%-42% of residents were prescribed PRN opioids over assessment periods ranging from one week to 30 months. Three studies reported 27%-50% of residents were dispensed an opioid over 12 months. Five studies reported 21%-29% were administered both regular and PRN opioids over 24 hours. Two studies reported 22%-42% of residents were administered PRN opioids over 1 week to 12 months. Two studies reported 6%-13% of residents were using doses >100 mg oral morphine equivalents/day.
Conclusions: Up to half of the residents were dispensed opioids over 12 months. The prevalence of opioid prescribing, dispensing and administration was highly variable, suggesting the potential value of opioid quality indicators and analgesic stewardship interventions to ensure opioid appropriateness.
|Item Type:||Refereed Article|
|Keywords:||aged, analgesics, opioid, pain, pain management|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Pharmacology and pharmaceutical sciences|
|Research Field:||Clinical pharmacy and pharmacy practice|
|Objective Group:||Clinical health|
|Objective Field:||Human pain management|
|UTAS Author:||Veal, F (Dr Felicity Veal)|
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