New study finds opioid use in Australian aged care 30 times higher than in Japanese residents

A new study has found that only 11 per cent of Japanese aged-care residents are prescribed regular painkiller medications, compared to Australia's 74 per cent.

Furthermore, the use of opioid painkiller medications was found to be 30 times higher in Australia.

The new study by Monash Univerisity and Japan's Institute of Health Economics and Policy compared painkiller use among two samples of Australian and Japanese residents with the goal of better understanding the pharmacological management of pain in residential aged care.

Opioid use is common for people aged 65 and over as it is frequently prescribed for health issues such as chronic pain or urinary tract infections.

Data from the Pharmaceutical Benefits Scheme (PBS) found that people over the age of 80 had the highest rates of scripts dispensed for opioids at 177 times higher than younger age groups.

However, long-term use poses a risk of drug dependence and severe side effects such as nausea or impact on the cardiovascular and endocrine systems.

People over the age of 55 account for 30 per cent of accidental opioid deaths.

Qualitative data obtained through focus groups with Australian and Japanese healthcare professionals highlighted the differences in therapeutic goals, painkiller regulations, and treatment durations between the two countries.

Lead author of the study and pharmacist Laura Dowd said these differences may explain the disparities in painkiller use between the respective countries.

"Australian participants described their therapeutic goal was to alleviate pain, and reported painkillers were often prescribed on a regular basis, whilst Japanese participants described their therapeutic goal was to minimise impacts of pain on daily activities, and reported opioid painkillers were prescribed for short-term durations, corresponding to episodes of pain," Ms Dowd said.

“Australia and Japan both have rapidly ageing populations but appear to have very different patterns of painkiller use.

"Understanding these differences can inform new initiatives to improve pain management."

Senior author Dr Amanda Cross said this research confirmed previous research by Monash University.

"This study confirms previous CMUS research that shows up to one-third of Australian residents are prescribed opioid painkiller medicines, and highlights key areas where on-site aged care pharmacists could work to support the appropriate use of opioids."

Dr Shota Hamada from the Institute for Health Economics and Policy said painkillers were one part of an effective pain management strategy and reliance on other factors should be made.

"Understanding the different role of painkillers as part of the overall approach to pain management will help the safe and effective painkiller use," he said.

In June 2020, the federal government made changes to regulations that manage the prescription and supply of opioids, which significantly impacted people with chronic pain.

It was criticised as a "one-dimensional strategy", with researchers showing a "one-size-fits-all" approach for reducing opioid use was not favoured.

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