When hospital patients are moved to a skilled nursing facility, they are too often given a prescription for a high-dose opioid painkiller, new research suggests.
For the study, researchers at the Oregon State University College of Pharmacy looked at nearly 4,400 hospital patients in Portland sent to nursing facilities to receive either short-term rehabilitative care or long-term care in a residential setting.
The investigators found that seven out of 10 of these patients received an opioid prescription when they left the hospital, and most were for oxycodone, or OxyContin.
Over half of the prescriptions dispensed were high-dose — equivalent to 90 milligrams of morphine or higher — a threshold that the U.S. Centers for Disease Control and Prevention advises doctors to “avoid” prescribing, according to a university news release.
Most of the patients who received an opioid prescription were over 65 years of age, an age group that is highly vulnerable to opioid-associated harm, the study authors noted.
The findings were published online recently in the journal Pharmacoepidemiology and Drug Safety.
The results emphasize the need for more attention to be paid to safely managing the pain of this patient group, the researchers concluded.
“Increased efforts are likely needed to optimize opioid prescribing among patients transitioning from hospitals to skilled nursing facilities,” said study author Jon Furuno, an associate professor at the university and the interim chair of the department of pharmacy practice.
Furuno pointed out that patients in nursing facilities may also be undertreated for their pain, showing the complexity of this issue.
“Prescribers and pharmacists need to work together to ensure patients’ pain is managed safely, and knowing which patients are most at risk can inform the best use of resources like medication counseling and other interventions,” Furuno said.
There’s more about opioid safety at the U.S. Department of Health and Human Services.
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