The Effect of Concurrent Use of Opioids and Gabapentin on Fall Risk in Older Adults

Falls pose a significant threat to older adults, resulting in injuries and mortality. Concurrently prescribed opioids and gabapentin for pain management may increase fall risks in older patients. This study aimed to estimate fall risks associated with the concurrent use of gabapentin and opioids, comparing them to opioid monotherapy in older adults. A retrospective case-control study of 1,813 patients aged 65–89 on chronic opioid therapy (2017–2020), excluding those with a fall history, analysis focused on the first fall occurrence. Logistic regression assessed the association between concurrent gabapentin and opioid use and fall events. Out of eligible patients, 122 (6.73%) experienced falls during opioid therapy, with 232 (12.80%) having concurrent gabapentin use. Concurrent use significantly increased fall risk (AOR = 1.73; 95% CI: 1.08-2.78). Being female, aged ≥81, and having more chronic conditions also increased risk. Mitigating fall risk in older adults requires education on prevention, exploring alternative pain management, and careful consideration of prescribing. Further research is crucial to understand adverse events linked to combined opioid and gabapentin use in the geriatric population.

跌倒对老年人群构成严重威胁，可导致损伤乃至死亡。同时开具阿片类药物（opioids）与加巴喷丁（gabapentin）用于疼痛管理，可能会升高老年患者的跌倒风险。本研究旨在评估老年人群联用加巴喷丁与阿片类药物相关的跌倒风险，并与阿片类药物单药治疗进行对比。本研究为回顾性病例对照研究，纳入2017至2020年间1813名年龄65~89岁、接受慢性阿片类药物治疗的患者，排除既往有跌倒史者，分析重点为首次跌倒事件。采用logistic回归分析，评估联用加巴喷丁与阿片类药物和跌倒事件之间的关联。在符合纳入标准的患者中，122例（6.73%）在阿片类药物治疗期间发生跌倒，其中232例（12.80%）联用了加巴喷丁。联用这两类药物可显著升高跌倒风险（调整后优势比[adjusted odds ratio, AOR]=1.73；95%置信区间[confidence interval, CI]=1.08~2.78）。女性、年龄≥81岁以及合并更多慢性疾病同样会升高跌倒风险。降低老年人群的跌倒风险，需开展跌倒预防教育、探索替代性疼痛管理方案，并谨慎考量处方用药。未来仍需开展进一步研究，以明确老年人群联用阿片类药物与加巴喷丁相关的不良事件。