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

Abstract

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.

Keywords:

• Opioids
• gabapentin
• falls
• older adults
• polypharmacy
• pain management
• adverse events
• medication safety

Acknowledgments

The authors of this study would like to extend our sincere appreciation to Adrian Jemal Williams, University of Arkansas for Medical Sciences (UAMS) Division of Pharmaceutical Evaluation and Policy, Research Program Manager, for his technical writing assistance and support for this study. Data for the study were provided by the Arkansas Clinical Data Repository (AR-CDR) maintained by the Department of Biomedical Informatics in the College of Medicine at the University of Arkansas for Medical Sciences (UAMS). The AR-CDR is approved to operate as an enterprise data resource to support research across UAMS. Data in the AR-CDR comes from UAMS Electronic Medical Record (EMR), tumor registry, billing, and cancer genomic data and comprises encounters since 05/01/2014.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.