Opioid Use Is Associated With Lower Health‐Related Quality of Life Among Community‐Dwelling Older Australians: A Cross‐Sectional Study From STAREE

BACKGROUND: Prescribed opioid use among older adults may have a reciprocal negative association with health-related quality of life (HrQoL), yet evidence on this relationship remains limited. This study evaluated the association between prescription opioid use and HrQoL in community-dwelling older adults. METHODS: We conducted a secondary cross-sectional analysis of baseline STAtins in Reducing Events in Elderly (STAREE) trial data, assessing the association between self-reported prescribed opioid use and HrQoL, via the 36-item Short Form Survey. Multivariable linear regression models assessed the association, with progressive adjustment for sociodemographic (Models 1 and 2), clinical (Model 3), and psychosocial factors (Model 4). Propensity score matching (PSM) was conducted to assess the robustness of the association. FINDINGS: The cohort included 479 opioid users and 9492 non-opioid users. users. In unadjusted analyses, opioid users had substantially lower mean HrQoL scores than non-users (β = -14.30; 95% CI: -15.59, -13.02). Adjustment for confounders attenuated the association, but it remained statistically significant in the fully adjusted model (β = -7.58; 95% CI: -8.80, -6.35). Lower scores among opioid users were observed across all HrQoL domains (Physical Functioning, Social Functioning, Role Limitations, Vitality, Bodily Pain, General Health and Mental Health), with the largest differences in physical functioning (approximately 20-25 points lower). CONCLUSION: Opioid use is associated with significantly poorer HrQoL in community-dwelling older adults, highlighting the importance of routinely assessing quality of life, functional status, and psychosocial factors among persons who use opioids. TRIAL REGISTRATION: This study was approved by Monash Human Research Ethics Committee (ID: 21528).