Grant: Summer Program in Aging

Background: Residents of long-term care (LTC) homes in Ontario are older, frailer, more vulnerable, and have higher care needs than those living in the community, and they are prescribed opioids nearly twice as often, despite the risks associated with opioid use. Recent clinical guidelines recommend deprescribing opioids when the risk of use outweigh the benefits. While recent research has focused on the deprescribing of other high-risk medications (e.g. antipsychotics), there has been limited research conducted on the characteristics and outcomes associated with deprescribing long-term opioid therapy for residents of LTC homes. Therefore, the purpose of this study is to examine opioid deprescribing among residents of LTC homes in Ontario receiving long-term opioid therapy. Methods: This research study will be conducted using a population-based retrospective cohort study design. The study cohort will include all residents of LTC homes, 66 years of age and and older, prescribed long-term opioid therapy (greater than three months). The primary exposure will be opioid deprescribing (tapering/reducing or discontinuation). The primary outcome will be healthcare utilization (emergency department visit or hospitalization), and the secondary outcomes will include mortality, opioid represcribing, and trends in pain, function, and cognition scales. Data will include a subset of the routinely collected health administrative databases held at the Institute for Clinical Evaluative Sciences. Implications: This study will provide an Ontario perspective of the characteristics and outcomes associated with opioid deprescribing for residents of LTC homes. The results will allow for recommendations to inform safe, quality person-centered care, identify knowledge gaps and potential educational opportunities for clinical staff, direct future research, and inform health policy regarding opioid deprescribing for residents of LTC homes.