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    Analgesic use and risk of recurrent falls in participants with or at risk of knee osteoarthritis: data from the Osteoarthritis Initiative

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    Analgesic use and risk of recurrent ...
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    Description:
    Final Accepted Manuscript
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    Author
    Lo-Ciganic, W.-H.
    Floden, L.
    Lee, J.K.
    Ashbeck, E.L.
    Zhou, L.
    Chinthammit, C.
    Purdy, A.W.
    Kwoh, C.K.
    Affiliation
    Univ Arizona, Coll Pharm, Dept Pharm Practice & Sci
    Univ Arizona, Coll Med, Arthrit Ctr
    Univ Arizona, Div Rheumatol, Dept Med
    Issue Date
    2017-09
    Keywords
    Analgesics
    Opioids
    Antidepressants
    Non-steroidal anti-inflammatory drugs
    Falls
    Knee osteoarthritis
    
    Metadata
    Show full item record
    Publisher
    ELSEVIER SCI LTD
    Citation
    Lo-Ciganic, W. H., Floden, L., Lee, J. K., Ashbeck, E. L., Zhou, L., Chinthammit, C., ... & Kwoh, C. K. (2017). Analgesic use and risk of recurrent falls in participants with or at risk of knee osteoarthritis: data from the Osteoarthritis Initiative. Osteoarthritis and cartilage, 25(9), 1390-1398.
    Journal
    OSTEOARTHRITIS AND CARTILAGE
    Rights
    © 2017 Osteoarthritis Research Society International; published by Elsevier Ltd on behalf of Osteoarthritis Research Society International.
    Collection Information
    This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.
    Abstract
    Objective: Few studies have compared the risk of recurrent falls across different types of analgesic use, and with limited adjustment for potential confounders (e.g., pain/depression severity). We assessed analgesic use and the subsequent risk of recurrent falls, among participants with or at risk of knee osteoarthritis (OA). Methods: A longitudinal analysis included 4231 participants aged 45-79 years at baseline with 4-year follow-up from the Osteoarthritis Initiative (OAI) cohort study. We grouped participants into six mutually exclusive subgroups based on annually assessed analgesic use in the following hierarchical order of analgesic/central nervous system (CNS) potency: use of (1) opioids, (2) antidepressants, (3) other prescription pain medications, (4) over-the-counter (OTC) pain medications, (5) nutraceuticals, and (6) no analgesics. We used multivariable modified Poisson regression models with a robust error variance to estimate the effect of analgesic use on the risk of recurrent falls (>= 2) in the following year, adjusted for demographics and health status/behavior factors. Results: Opioid use increased from 2.7% at baseline to 3.6% at the 36-month visit (>80% using other analgesics/nutraceuticals), while other prescription pain medication use decreased from 16.7% to 11.9% over this time period. Approximately 15% of participants reported recurrent falls. Compared to those not using analgesics, participants who used opioids and/or antidepressants had a 22-25% increased risk of recurrent falls (opioids: RRadjusted = 1.22, 95% CI = 1.04-1.45; antidepressants: RRadjusted = 1.25, 95% CI = 1.10-1.41). Conclusion: Participants with or at risk of knee OA who used opioids and antidepressants with/without other analgesics/nutraceuticals may have an increased risk of recurrent falls after adjusting for potential confounders. Use of opioids and antidepressants warrants caution. Published by Elsevier Ltd on behalf of Osteoarthritis Research Society International.
    Description
    12 month embargo; available online 4 April 2017.
    ISSN
    10634584
    DOI
    10.1016/j.joca.2017.03.017
    Version
    Final accepted manuscript
    Sponsors
    University of Arizona Health Sciences Career Development Award; National Institutes of Health, a branch of the Department of Health and Human Services [N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, N01-AR-2-2262]; Merck Research Laboratories; Novartis Pharmaceuticals Corporation; GlaxoSmithKline; Pfizer, Inc.; Foundation for the National Institutes of Health
    Additional Links
    https://linkinghub.elsevier.com/retrieve/pii/S106345841730938X
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.joca.2017.03.017
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