More Than Half of Hospitalized Patients Given Opioids
Relative risk of severe opioid-related adverse event up at hospitals with higher opioid prescribing
WEDNESDAY, Nov. 20, 2013 (HealthDay News) -- More than half of hospitalized, nonsurgical patients are exposed to opioids, according to a study published online Nov. 13 in the Journal of Hospital Medicine.
Shoshana J. Herzig, M.D., M.P.H., from Beth Israel Deaconess Medical Center in Boston, and colleagues analyzed data from 1.14 million adult nonsurgical admissions to 286 U.S. hospitals to examine patterns and predictors of opioid utilization. International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify opioid exposure and severe opioid-related adverse events during hospitalization.
The researchers found that opioids were used in more than half (51 percent) of admissions. The mean daily dose received in oral morphine equivalents was 68 ± 185 mg, and almost one-quarter of those exposed (23 percent) received a total daily dose of ≥100 mg oral morphine equivalents. The mean opioid prescribing rate was 51 percent, with rates ranging from 5 percent in the lowest-prescribing hospital to 72 percent in the highest-prescribing hospital. The adjusted opioid-prescribing rates ranged from 33 percent to 64 percent (mean, 50 percent), after adjustment for patient characteristics. The adjusted relative risk of a severe opioid-related adverse event was increased at hospitals with higher opioid prescribing rates (relative risk, 1.23 for highest- versus lowest-prescribing quartile).
"Interventions to standardize and enhance the safety of opioid prescribing in hospitalized patients should be investigated," the authors conclude.