(HealthDay News) — Specific patterns of opioid administration to opioid-naive inpatients are associated with risk for long-term use after discharge, according to a study published online in the Annals of Internal Medicine.
Julie M. Donohue, PhD, from the University of Pittsburgh Graduate School of Public Health, and colleagues conducted a retrospective cohort study involving 148,068 opioid-naive patients with at least one outpatient encounter within 12 months before and after admission.
The researchers found that opioids were administered in 48% of admissions. Patients received opioids for a mean of 67.9% of their stay. After adjustment for potential confounders, outpatient use at 90 days was seen for 5.9 and 3.0% of inpatients receiving opioids and those without inpatient use, respectively. Higher 90-day opioid use was seen for inpatients receiving opioids less than 12 hours before discharge vs those with ≥24 opioid-free hours before discharge (7.5 vs 3.9%). Modest differences were seen based on the proportion of the stay with opioid use (opioid use at 90 days, 6.4 vs 5.4% for those with opioid use of ≥75% vs ≤25% of their hospital stay). Similar associations were seen for opioid use at 365 days after discharge.
“Our findings also highlight specific patterns of inpatient opioid prescribing that are associated with continued outpatient use and are likely amenable to health system interventions,” the authors write.
Donohue JM, Kennedy JN, Seymour CW, et al. Patterns of Opioid Administration Among Opioid-Naive Inpatients and Associations With Postdischarge Opioid Use: A Cohort Study. Ann Intern Med. doi:10.7326/M18-2864