Opiate Prescribing in Hospitalized Older Adults: Patterns and Outcomes
- 20 October 2017
- journal article
- research article
- Published by Wiley in Journal of the American Geriatrics Society
- Vol. 66 (1), 70-75
- https://doi.org/10.1111/jgs.15127
Abstract
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. Retrospective cohort study. Tertiary care facility. Hospitalized medical patients aged 65 and older (N = 9,245; mean age 80.3, 55.2% female, 72.3% white, 90.8% non-Hispanic). 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. 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). 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.This publication has 22 references indexed in Scilit:
- Use of Opioid Agonist Therapy for Medicare Patients in 2013JAMA Psychiatry, 2016
- Pain and Cognitive Function Among Older Adults Living in the CommunityThe Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 2015
- Prescription Opioids and Risk of Dementia or Cognitive Decline: A Prospective Cohort StudyJournal of the American Geriatrics Society, 2015
- The Prescription Opioid and Heroin Crisis: A Public Health Approach to an Epidemic of AddictionAnnual Review of Public Health, 2015
- The Prevalence of Diagnosed Opioid Abuse in Commercial and Medicare Managed Care PopulationsPain Practice, 2013
- Are Older Adults with Chronic Musculoskeletal Pain Less Active than Older Adults Without Pain? A Systematic Review and Meta-AnalysisPain Medicine, 2013
- Potentially inappropriate prescribing (IP) for elderly medical inpatients in Taiwan: A hospital-based studyArchives of Gerontology and Geriatrics, 2012
- The Association Between Noncancer Pain, Cognitive Impairment, and Functional Disability: An Analysis of the Canadian Study of Health and AgingThe Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 2010
- Chronic Pain and Poor Self-rated HealthJAMA, 2003
- The epidemiology of chronic pain in the communityThe Lancet, 1999