Initiation of Long‐Acting Opioids Following Hospital Discharge Among Medicare Beneficiaries. Issue 12 (17th November 2021)

• Record Type: Journal Article
• Authors: Deshpande, Bhushan R; McCarthy, Ellen P; Jung, Yoojin; Anderson, Timothy S; Herzig, Shoshana J
• Is Part Of: Journal of hospital medicine. Volume 16:Issue 12(2021)
• Page Start: 724
• Page End: 726
• Publication Date: 2021-11-17
• Subjects: Hospital care -- Periodicals; Clinical medicine -- Periodicals; 610
• DOI: 10.12788/jhm.3721
• Languages: English
• ISSNs: 1553-5592

Abstract

Abstract : Guidelines recommend against initiating long‐acting opioids during acute hospitalization, owing to higher risk of overdose and morbidity compared to short‐acting opioid initiation. We investigated the incidence of long‐acting opioid initiation following hospitalization in a retrospective cohort of Medicare beneficiaries with an acute care hospitalization in 2016 who were ≥65 years old, did not have cancer or hospice care, and had not filled an opioid prescription within the preceding 90 days. Among 258, 193 hospitalizations, 47, 945 (18.6%) were associated with a claim for a new opioid prescription in the week after hospital discharge: 817 (0.3%) with both short‐ and long‐acting opioids, 125 (0.1%) with long‐acting opioids only, and 47, 003 (18.2%) with short‐acting opioids only. Most long‐acting opioid claims occurred in surgical patients (770 out of 942; 81.7%). Compared with beneficiaries prescribed short‐acting opioids only, beneficiaries prescribed long‐acting opioids were younger, had a higher prevalence of diseases of the musculoskeletal system and connective tissue, and had more known risk factors for opioid‐related adverse events, including anxiety disorders, opioid use disorder, prior long‐term high‐dose opioid use, and benzodiazepine co‐prescription. These findings may help target quality‐improvement initiatives.