Older Adult-Onset of Inflammatory Bowel Diseases is Associated With Higher Utilization of Analgesics: A Nationwide Cohort Study

INTRODUCTION: Patients with inflammatory bowel diseases (IBD) commonly require analgesic medications to treat pain, which may be associated with complications. We examined trends of analgesic use according to age of IBD onset.

METHODS: This nationwide cohort study included adults diagnosed with IBD between 1996-2021 in Denmark. Patients were stratified according to their age of IBD onset: 18-39 years (young adult), 40-59 years (adult), and 60+ years (older adult). We examined the proportion of patients who received prescriptions for analgesic medications within 1 year after IBD diagnosis: strong opioids, tramadol, codeine, non-steroidal anti-inflammatory drugs (NSAIDs), and paracetamol. Multivariable logistic regression was performed to examine the association between age of IBD onset with strong opioid prescriptions and the composite of strong opioid/tramadol/codeine prescriptions.

RESULTS: We identified 54,216 adults with IBD. Among these, 25,184 (46.5%) were young adults, 16,106 (29.7%) were adults, and 12,926 (23.8%) were older adults at IBD onset. Older adults most commonly received analgesic prescriptions of every class. Between 1996-2021, strong opioid, tramadol, and codeine prescriptions were stable while paracetamol prescriptions increased and NSAID prescriptions decreased. After multivariable logistic regression, older adults had higher adjusted odds of receiving strong opioid prescriptions (aOR 1.95, 95%CI 1.77-2.15) and the composite of strong opioid/tramadol/codeine prescriptions (aOR 1.93, 95%CI 1.81-2.06) within 1 year after IBD diagnosis compared to adults.

DISCUSSION: In this nationwide cohort, older adults most commonly received analgesic prescriptions within 1 year after IBD diagnosis. Additional research is needed to examine the etiology and sequelae of increased analgesic prescribing to this demographic.