Inpatient opioid prescribing patterns and their effect on rehospitalisations: a nested case-control study using data from a Swiss public acute hospital

Opioid prescriptions have increased in Switzerland, even though current guidelines warn of their harms. If opioids for postoperative analgesia are not tapered before hospital discharge, patients are at risk of adverse events such as constipation, drowsiness, dependence, tolerance and withdrawal. The...

Full description

Saved in:
Bibliographic Details
Published in:Swiss medical weekly 2024-08, Vol.154 (8), p.3391
Main Authors: Stanisic, Aleksandra, Stämpfli, Dominik, Schulthess Lisibach, Angela E, Lutters, Monika, Burden, Andrea M
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Analgesics, Opioid - therapeutic use
Case-Control Studies
Drug Prescriptions - statistics & numerical data
Female
Hospitals, Public - statistics & numerical data
Humans
Inpatients - statistics & numerical data
Male
Pain, Postoperative - drug therapy
Patient Discharge - statistics & numerical data
Patient Readmission - statistics & numerical data
Practice Patterns, Physicians' - statistics & numerical data
Switzerland
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Opioid prescriptions have increased in Switzerland, even though current guidelines warn of their harms. If opioids for postoperative analgesia are not tapered before hospital discharge, patients are at risk of adverse events such as constipation, drowsiness, dependence, tolerance and withdrawal. The aim of this study was to investigate and quantify the potential association between opioids prescribed at discharge from hospital and rehospitalisation. We conducted a nested case-control study using routinely collected electronic health records from a Swiss public acute hospital. Cases were patients aged 65 years or older admitted between November 2014 and December 2018, with documented opioid administration on the day of discharge and rehospitalisation within 18 or 30 days after discharge. Each case was matched to five controls for age, sex, year of hospitalisation and Charlson Comorbidity Index. We calculated odds ratios for 18-day and 30-day rehospitalisation based on exposure to opioids using a conditional logistic regression adjusted for potential confounders. Secondary analyses included stratifications into morphine-equivalent doses of
ISSN:1424-3997
1424-3997
DOI:10.57187/s.3391