Title
Opioid prescribing on discharge to skilled nursing facilities
UMMS Affiliation
Department of Population and Quantitative Health Sciences
Publication Date
2020-07-29
Document Type
Article
Disciplines
Clinical Epidemiology | Epidemiology | Geriatrics | Health Services Administration | Health Services Research | Patient Safety | Pharmacy Administration, Policy and Regulation
Abstract
PURPOSE: Skilled nursing facility (SNF) residents are at increased risk for opioid-related harms. We quantified the frequency of opioid prescribing among patients discharged from an acute care hospital to SNFs.
METHODS: This was a retrospective cohort study among adult ( > /=18 years) inpatients discharged from a quaternary-care academic referral hospital in Portland, OR to a SNF between January 1, 2017 and December 31, 2018. Our primary outcome was receipt of an opioid prescription on discharge to a SNF. Our exposures included patient demographics (eg, age, sex), comorbid illnesses, surgical diagnosis related group (DRG), receiving opioids on the first day of the index hospital admission, and inpatient hospital length of stay.
RESULTS: Among 4374 patients discharged to a SNF, 3053 patients (70%) were prescribed an opioid on discharge. Among patients prescribed an opioid, 61% were over the age of 65 years, 50% were male, and 58% had a surgical Medicare severity diagnosis related group (MS-DRG). Approximately 70% of patients discharged to a SNF were prescribed an opioid on discharge, of which 68% were for oxycodone, and 52% were for > /=90 morphine milligram equivalents per day. Surgical DRG, diagnoses of cancer or chronic pain, last pain score, and receipt of an opioid on first day of the index hospital admission were independently associated with being prescribed an opioid on discharge to a SNF.
CONCLUSION: Opioids were frequently prescribed at high doses to patients discharged to a SNF. Efforts to improve opioid prescribing safety during this transition may be warranted.
Keywords
nursing homes, opioid prescribing, pharmacoepidemiology, skilled nursing facilities, transitions of care
DOI of Published Version
10.1002/pds.5075
Source
Hubsky AR, Noble BN, Hartung DM, Tjia J, Lapane KL, Furuno JP. Opioid prescribing on discharge to skilled nursing facilities. Pharmacoepidemiol Drug Saf. 2020 Jul 29. doi: 10.1002/pds.5075. Epub ahead of print. PMID: 32725962. Link to article on publisher's site
Journal/Book/Conference Title
Pharmacoepidemiology and drug safety
PubMed ID
32725962
Related Resources
Repository Citation
Hubsky AR, Noble BN, Hartung DM, Tjia J, Lapane KL, Furuno JP. (2020). Opioid prescribing on discharge to skilled nursing facilities. Population and Quantitative Health Sciences Publications. https://doi.org/10.1002/pds.5075. Retrieved from https://escholarship.umassmed.edu/qhs_pp/1361