Opioid Use Among Older Adults After Hip Fracture: Study Reveals Patterns and Racial Disparities

A recent study published in the Journal of the American Medical Directors Association has shed light on the use of pain medication, including opioids, among older adults discharged to skilled nursing facilities (SNFs) after hip fractures. The research, conducted by a team of researchers from Brown University School of Public Health, analyzed Medicare claims data linked to medication dispensing records from a large commercial SNF pharmacy.

Key Takeaways:

• The study found that 83.7% of eligible individuals received any pain medication in the 100 days after SNF admission, with hydrocodone plus acetaminophen being the most prevalent pain medication regimen (16.7% prevalence overall).
• Among those prescribed a gabapentinoid in the first 15 days after hospitalization, 91% were co-prescribed an opioid, regardless of prior gabapentinoid use before the hip fracture.
• The prevalence of any pain medication dispensing was similar between sexes and race/ethnicity subgroups, but medication regimens differed by race/ethnicity.
• Most individuals who received a gabapentinoid immediately after SNF admission were co-prescribed an opioid.
• The study notes an urgent need for closer medication management in SNFs to ensure adequate pain control after hip fracture while minimizing potentially harmful analgesic combinations.

Statistics:

• 88,433 eligible individuals (average age at SNF entry = 84.8 years, 76.7% female) were matched and included in the study.
• 16.7% of participants received hydrocodone plus acetaminophen, while 11.2% received oxycodone plus acetaminophen.
• Dispensing of most medication regimens, particularly opioid-based regimens, declined by more than 50% by day 30 after SNF admission.
• By days 60 to 100, an increase in use of several opioid-based regimens was observed.

Sources:

• Longitudinal Pain Medication Use Among US Older Adults After a Hip Fracture. Journal of the American Medical Directors Association, 2025:105922.
• Journal of the American Medical Directors Association can be contacted at: Elsevier Science Inc, Ste 800, 230 Park Ave, New York, NY 10169, USA.
• Andrew R. Zullo, Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, RI, United States.
• Lexie R. Grove, Daniel A. Harris, Oshin Miranda, Richa Joshi, Meghan A. Cupp, Francesca L. Beaudoin, Melissa R. Riester, and Kaleen N. Hayes.