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Opioids after hospitalization reduce planned health care utilization in ACS, HF
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Patients with ACS and acute decompensated HF who were discharged with an opioid medication were less likely to utilize planned health care, according to a study published in the Journal of the American Heart Association.
The primary outcome of the study, unplanned health care utilization, was not significant.
“Hospital discharge provides a unique opportunity to evaluate each patient’s medication regimen,” Justin S. Liberman, MD, MPH, assistant professor of anesthesiology at Vanderbilt University Medical Center in Nashville, Tennessee, said in a press release. “It’s important for health care providers to understand the other ways that opioids may affect a patient’s future interactions with the health care system.”
Researchers analyzed data from 2,495 patients from the Vanderbilt Inpatient Cohort Study who were hospitalized for ACS and/or acute decompensated HF between October 2011 and December 2015. Patients completed questionnaires during the index hospitalization to collect information on medication use, social and behavioral risk factors, and health status. Follow-up was conducted by telephone interviews at 2, 3, 30 and 90 days.
Charts were reviewed regarding health care utilization during 90 days after discharge. In addition, the discharge medication list was assessed for the presence of an opioid medication.
The primary outcome of interest was the time from the index hospital discharge until the utilization of unplanned health care within the 90 days after discharge, which was defined as hospital readmission or an ED visit. Secondary outcomes of interest included completion of planned health care utilization and time to all-cause mortality.
Of the patients in the study, 20% (mean age, 59 years; 50% men) were discharged an opioid prescription.
The association between increased mortality (adjusted HR = 1.08; 95% CI, 0.84-1.39) or unplanned utilization (aHR = 1.06; 95% CI, 0.87-1.28) was statistically insignificant in patients with opioids at discharge vs. those without opioids.
Planned health care utilization was less likely to be completed in patients who were discharged with opioids (aOR = 0.69; 95% CI, 0.52-0.91).
“Our study supports reductions in opioid prescriptions to improve planned health care utilization behaviors,” Liberman and colleagues wrote. “Further research is necessary to understand opioid use and its association with patient self-care to improve clinical outcomes.” – by Darlene Dobkowski
Disclosures: The authors report no relevant financial disclosures.
Editor’s Note: This article was updated on March 7, 2019 to correct that the outcomes of increased mortality and unplanned utilization were not significant. The Editors regret the error.
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