Evaluation of Hospitalized Patients Receiving High versus Low-Dose Opioids for Non-Cancer Pain.
Catherine H MooreKatherine L MarchJoanna Q HudsonChristopher K FinchJennifer D TwillaPublished in: Journal of pain & palliative care pharmacotherapy (2022)
Limited studies suggest that opioid-related adverse effects (ORAEs) may worsen hospitalized patient outcomes, but there is insufficient data related to the impact of high-dose opioids compared to low-dose on adverse patient events. Given the paucity of data, our study aims to evaluate these ORAEs in the general hospitalized patient with non-cancer pain. A retrospective study of adult patients receiving opioids with a primary diagnoses of myocardial infarction, chronic obstructive pulmonary disease, heart failure, pneumonia, sepsis, or diabetes was conducted. Average oral morphine milligram equivalents (MMEs) administered over the entire LOS was collected, and patients were categorized as high-dose (≥50 MMEs/day) or low-dose (<50 MMEs/day). The primary composite endpoint was the incidence of ORAEs (naloxone use, decreased oxygen saturations, nausea/vomiting). Secondary outcomes included LOS, 30-day readmission, ORAEs with >100 MMEs/day. A total of 100 patients were included (n = 58 low-dose group; n = 42 high-dose group). For the primary outcome, more patients in the high-dose group experienced ORAEs (50% high-dose vs. 22.4% low-dose; p < 0.006). No statistically significant differences in LOS or 30-day readmission rates were identified between the groups. For patients receiving >100 MMEs/day, ORAEs occurred in 61% of patients. Hospitalized patients receiving high-dose opioids for non-cancer pain may have an increased incidence of ORAEs.
Keyphrases
- high dose
- low dose
- chronic pain
- end stage renal disease
- heart failure
- stem cell transplantation
- pain management
- newly diagnosed
- chronic kidney disease
- chronic obstructive pulmonary disease
- ejection fraction
- prognostic factors
- cardiovascular disease
- squamous cell carcinoma
- type diabetes
- metabolic syndrome
- risk factors
- spinal cord injury
- electronic health record
- acute kidney injury
- cystic fibrosis
- young adults
- skeletal muscle
- left ventricular
- atrial fibrillation
- insulin resistance
- weight loss
- big data
- deep learning
- patient reported
- postoperative pain