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Heroin Addiction and Related Clinical Problems: 2024, 26, 2

Somatic and mental health among older patients in opioid agonist therapy: a cross-sectional geriatric assessment study

Lennart Niels Mayer-Eckardt, Ole Gnirss, Maximilian Meyer, Katharina Roser, Kenneth M. Dürsteler, and Marc Vogel

Digital Object Identifier:
https://doi.org/10.62401/2531-4122-2024-2

Summary: Background: Opioid-dependent persons age prematurely. However, studies comprehensively assessing the health of older patients in opioid agonist therapy (OAT) are lacking. Aim: This study aims to characterise the ageing opioid-dependent population in Switzerland through a comprehensive geriatric assessment of physical and mental health conditions in a convenience sample of older patients in OAT. Methods: We performed a comprehensive geriatric assessment of physical and mental health conditions in 61 OAT patients aged ≥ 49 years in Basel, Switzerland. The evaluation comprised medical anamnesis, substance use (self-report and urinalysis), health-related quality of life (HRQOL), medical chart review and clinical examination, including spirometry, functional diagnostics, and blood testing. Data on HRQOL was compared with the general German-speaking Swiss population. Results: The assessment yielded a high prevalence of somatic (72.2% according to self-report, 83.6% according to medical chart review) and mental conditions (60.0% according to self-report, 77.0% according to medical chart review), which participants were frequently unaware of. Geriatric symptoms, concurrent substance use, and polypharmacy were highly prevalent. The geriatric assessment identified previously unknown health problems and led to further diagnostic or therapeutic measures in 73% of cases. HRQOL was significantly lower compared to both age-matched and geriatric reference groups. Conclusions: Age-related health conditions are overly common but frequently overlooked in patients receiving OAT. Regular assessments and integrative approaches to geriatric and addiction care could improve the identification and treatment of age-related conditions. Recent geriatric symptoms and HRQOL should be considered an endpoint when evaluating the treatment of older OAT patients.

Keywords: Opioid agonist therapy; aging; geriatric conditions; health-related quality of life