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We examined the patterns of and factors associated with opioid use in older people diagnosed with cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used the Department of Veterans' Affairs (DVA) client data linked with the New South Wales (NSW) Cancer Registry and the Repatriation Pharmaceutical Benefits Scheme data. We included people aged \u226565\u2009years diagnosed with cancer in NSW, Australia in 2005 to 2015. We examined patterns of opioid use in the 12\u2009months after cancer diagnosis and used cause\u2010specific hazards models to examine factors associated with opioid use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 13\u2009527 people diagnosed with cancer, 51% were dispensed opioids after their diagnosis. We observed the highest proportions of use in people diagnosed with pancreas, liver, or lung cancers. Opioid use was associated with female sex, younger age, more advanced degree of cancer spread, opioid use before cancer diagnosis, and multimorbidity. Forty\u2010four percentages of all people dispensed opioids had a history of opioid use in the 12\u2009months before their cancer diagnosis; these people had higher median number of different opioids and opioid dispensings, and a shorter time to first opioid dispensing than opioid\u2010naive people.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study suggests that many older cancer patients were dispensed opioids before their cancer diagnosis. Previously opioid\u2010treated people had more intense opioid use patterns after diagnosis than opioid\u2010na\u00efve people. Acknowledging the history of opioid use is important as it may complicate pain treatment in clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.5081","type":"journal-article","created":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T02:15:49Z","timestamp":1602555349000},"page":"360-370","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Patterns of opioid use in older people diagnosed with cancer in New South Wales, Australia"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1211-9709","authenticated-orcid":false,"given":"Hanna E","family":"Tervonen","sequence":"first","affiliation":[{"name":"Medicines Policy Research Unit Centre for Big Data Research in Health, UNSW Sydney  Kensington New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3701-4997","authenticated-orcid":false,"given":"Andrea L","family":"Schaffer","sequence":"additional","affiliation":[{"name":"Medicines Policy Research Unit Centre for Big Data Research in Health, UNSW Sydney  Kensington New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Luckett","sequence":"additional","affiliation":[{"name":"Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health University of Technology Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Phillips","sequence":"additional","affiliation":[{"name":"Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health University of Technology Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melisa","family":"Litchfield","sequence":"additional","affiliation":[{"name":"Medicines Policy Research Unit Centre for Big Data Research in Health, UNSW Sydney  Kensington New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Todd","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Faculty of Medical Sciences Newcastle University  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sallie\u2010Anne","family":"Pearson","sequence":"additional","affiliation":[{"name":"Medicines Policy Research Unit Centre for Big Data Research in Health, UNSW Sydney  Kensington New South Wales Australia"},{"name":"Menzies Centre for Health Policy, School of Public Health, Charles Perkins Centre The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdp001"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.52.4629"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2015.12.340"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.suronc.2009.11.009"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(12)70040-2"},{"issue":"7","key":"e_1_2_11_7_1","first-page":"CD012592","article-title":"Opioids for cancer pain\u2014an overview of Cochrane reviews","author":"Wiffen PJ","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_11_8_1","first-page":"514","article-title":"Is the WHO analgesic ladder still valid? 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