Opiate Prescribing in Hospitalized Older Adults: Patterns and Outcomes.

Publication Date

2018

Journal Title

J Am Geriatr Soc

Abstract

BACKGROUND/OBJECTIVES: Whereas opiate prescribing patterns have been well described in outpatient and emergency department settings, they have been less defined in hospitalized older adults. The objective was to describe patterns of opiate prescribing and associated outcomes in hospitalized older adults.

DESIGN: Retrospective cohort study.

SETTING: Tertiary care facility.

PARTICIPANTS: Hospitalized medical patients aged 65 and older (N = 9,245; mean age 80.3, 55.2% female, 72.3% white, 90.8% non-Hispanic).

MEASUREMENTS: Opiate exposure and duration of action, concurrent use of potentially inappropriate medications (PIMs), adverse events, discharge disposition, length of stay (LOS), and 30-day readmissions.

RESULTS: There was no difference in sex, race, ethnicity, or Charlson Comorbidity Index between opiate exposure groups. Participants who had never received opiates had a significantly shorter mean LOS than prior and new opiate users (5.2, 6.8, 7.7 days; P < .001) and were more likely to be discharged home (88.6%, 82.8%, 82.5%; P < .001) and significantly less likely to be readmitted within 30-days (19.6%, 25.0%, 22.3%; P < .001). Participant who had never been exposed to opiates had a significantly shorter mean LOS than those receiving short- and long-acting opiates (5.2, 7.3, 8.6 days; P < .001) and were more likely to be discharged home (88.6%, 82.6%, 82.4%; P < .001) and significantly less likely to be readmitted within 30-days (19.6%, 27.7%, 28.9%; P < .001).

CONCLUSION: Opiate use is widespread during hospitalization and is associated with significant negative clinical outcomes and quality metrics. There is an urgent need to develop innovative pain management alternatives to opiate use.

Volume Number

66

Issue Number

1

Pages

70-75

Document Type

Article

Status

Faculty, Northwell Researcher, Northwell Resident

Facility

School of Medicine; Northwell Health

Primary Department

Hospital Medicine

Additional Departments

General Internal Medicine; Occupational Medicine, Epidemiology and Prevention

PMID

29052224

DOI

10.1111/jgs.15127

For the public and Northwell Health campuses

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