Study, research letter examine aspects of opioid prescribing, sharing
Pain-relieving prescription opioids are the subject of a new original investigation and research letter published online by JAMA Internal Medicine.
In the original investigation, Anupam B. Jena, M.D., Ph.D., of Harvard Medical School, Boston, and coauthors analyzed pharmacy claims from a 20 percent random sample of Medicare beneficiaries in 2011 to estimate the frequency of opioid prescribing at hospital discharge among those patients who did not have an opioid prescription 60 days prior to hospitalization.
Among, 623,957 hospitalizations, 14.9 percent (n=92,882) were associated with a new opioid claim within seven days of discharge. Across 2,512 hospitals the average rate of new opioid use within seven days of hospitalization was 15.1 percent. New opioid claims varied among hospitals, the authors report.
Among 77,092 of the 92,882 hospitalizations with a 90-day follow-up, 42.5 percent (n=32,731) were associated with an opioid claim 90 days after discharge, the study also reports.
Limitations of the study include that authors were unable to determine whether the observed variation in opioid use after hospital discharge was related to appropriate or inappropriate prescribing variation.
"Among Medicare patients without opioid use in the 60 days prior to hospitalization, prescribing of opioids at the time of hospital discharge is common, with substantial variation across hospitals and a large proportion of patients using a prescription opioid 90 days after hospitalization," the study concludes.
In a related research letter, Alene Kennedy-Hendricks, Ph.D., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, and coauthors surveyed U.S. adults with recent opioid medication use to examine sharing, storing and disposal of the medication.
The survey was completed by 1,032 individuals determined to be eligible based on their past-year use of opioid medications.
About 20.7 percent of survey respondents reported ever having shared opioid medication; only 8.6 percent reported most often keeping the medication in a location that locks; and 61.3 percent reported keeping leftover opioid medication for future use even though they were no longer using the medication, according to the results.
A limitation of the study was its use of self-reported data, which can be subject to bias.
"More research is needed to identify effective strategies to advance safer practices related to opioid medication sharing, storage and disposal. In the meantime, reducing the prescribing of large quantities of opioid medications and disseminating clear recommendations on safe storage and disposal of opioid medications widely to the public and prescribers may reduce risks," the research letter concludes.
Kennedy-Hendricks et al. JAMA Intern Med. Published online June 13, 2016. DOI: 10.1001/jamainternmed.2016.2543