Does Transient Opioid Use Increase Risk of Short-Term Respiratory Exacerbation among Older Adults with Chronic Obstructive Pulmonary Disease?

Figures & data

Table 1. Baseline characteristics of COPD respiratory exacerbations.

Characteristics	Event-level characteristics (N = 16 290)	Patient-level characteristics (N = 12 446)
Age
Mean (SD)	77.08 (7.34)	77.29 (7.53)
Sex
Male	5838 (35.8%)	4572 (36.7%)
Female	10 452 (64.2%)	7874 (63.3%)
Race
Caucasian	15 235 (93.5%)	11 617 (93.3%)
African American	794 (4.9%)	627 (5.0%)
Other	233 (1.4%)	183 (1.5%)
Unknown	28 (0.2%)	19 (0.2%)
Use of long-acting Bronchodilators	5059 (31.1%)	4024 (32.3%)
Use of short-acting Bronchodilators	4801 (29.5%)	3935 (31.6%)
Use of inhaled corticosteroids	385 (2.4%)	340 (2.7%)
Use of oral corticosteroids	5563 (34.2%)	4,529 (36.4%)
Use of methylxanthines	393 (2.4%)	297 (2.4%)
Use of PDE4 inhibitors	301 (1.9%)	218 (1.8%)
Use of antibiotics	6707 (41.2%)	5623 (45.2%)
Use of benzodiazepines	4729 (29.0%)	3667 (29.5%)
Use of β-blockers	7190 (44.1%)	5874 (47.2%)
Lower respiratory tract infection	2998 (18.4%)	2729 (21.9%)
Upper respiratory tract infection	1184 (7.3%)	1120 (9%)
Asthma exacerbation	38 (0.2%)	37 (0.3%)

Table 2. Conditional logistic regression of opioid use (dichotomous) and respiratory exacerbation of COPD among medicare beneficiaries, 2012–2016.

	Within seven-day respiratory exacerbation
	OR	95% CI		P-value
Use of opioid (Y/N)	1.76	1.67	1.84	<0.001
Use of long-acting bronchodilators	2.80	2.51	3.13	<0.001
Use of short-acting bronchodilators	2.04	1.86	2.23	<0.001
Use of inhaled corticosteroids	2.50	1.75	3.57	<0.001
Use of oral corticosteroids	2.68	2.47	2.90	<0.001
Use of methylxanthines	4.78	2.93	7.80	<0.001
Use of PDE4 inhibitors	2.46	1.51	4.01	<0.001
Use of antibiotics	2.32	2.18	2.48	<0.001
Use of benzodiazepines	2.28	2.05	2.54	<0.001
Use of β-blockers	8.45	7.49	9.54	<0.001
Lower respiratory tract infection	2.12	1.93	2.34	<0.001
Upper respiratory tract infection	1.49	1.28	1.74	<0.001
Asthma exacerbation	2.88	1.16	7.14	0.022

Table 3. Conditional logistic regression of opioid use (continuous) and respiratory exacerbation of COPD among medicare beneficiaries, 2012–2016.

	Within seven-day respiratory exacerbation
	OR	95% CI		P-value
Use of opioid (25 mg MEDD)	1.18	1.15	1.21	<0.001
Use of long-acting bronchodilators	2.84	2.55	3.17	<0.001
Use of short-acting bronchodilators	2.08	1.90	2.28	<0.001
Use of inhaled corticosteroids	2.56	1.79	3.66	<0.001
Use of oral corticosteroids	2.75	2.53	2.98	<0.001
Use of methylxanthines	4.84	2.97	7.89	<0.001
Use of PDE4 inhibitors	2.49	1.52	4.08	<0.001
Use of antibiotics	2.38	2.23	2.54	<0.001
Use of benzodiazepines	2.39	2.15	2.66	<0.001
Use of β-blockers	8.89	7.88	10.03	<0.001
Lower respiratory tract infection	2.13	1.93	2.35	<0.001
Upper respiratory tract infection	1.48	1.26	1.72	<0.001
Asthma exacerbation	2.86	1.17	7.00	0.021

Data availability statement

All study data are available from the Centers for Medicare and Medicaid Services upon request.