Evaluation of a novel metric for personalized opioid prescribing after hospitalization

Nicholas R Iverson, Catherine Y Lau, Yumiko Abe-Jones, Margaret C Fang, Kirsten N Kangelaris, Priya Prasad, Sachin J Shah and Nader Najafi

PLOS ONE, 2020, vol. 15, issue 12, 1-12

Abstract: Background: The duration of an opioid prescribed at hospital discharge does not intrinsically account for opioid needs during a hospitalization. This discrepancy may lead to patients receiving much larger supplies of opioids on discharge than they truly require. Objective: Assess a novel discharge opioid supply metric that adjusts for opioid use during hospitalization, compared to the conventional discharge prescription signature. Design, setting, & participants: Retrospective study using electronic health record data from June 2012 to November 2018 of adults who received opioids while hospitalized and after discharge from a single academic medical center. Measures & analysis: We ascertained inpatient opioids received and milligrams of opioids supplied after discharge, then determined days of opioids supplied after discharge by the conventional prescription signature opioid-days (“conventional days”) and novel hospital-adjusted opioid-days (“adjusted days”) metrics. We calculated descriptive statistics, within-subject difference between measurements, and fold difference between measures. We used multiple linear regression to determine patient-level predictors associated with high difference in days prescribed between measures. Results: The adjusted days metric demonstrates a 2.4 day median increase in prescription duration as compared to the conventional days metric (9.4 vs. 7.0 days; P

Date: 2020
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0244735

DOI: 10.1371/journal.pone.0244735

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