Multimorbidity and Opioid Prescribing in Hospitalized Older Adults
| Autor: | Sarah K. Garrigues, Sarah Schear, Nicole Thompson, Ingrid Maravilla, Christine Miaskowski, Christine S. Ritchie, Andrew D. Auerbach, Lisa X. Deng, Kanan Patel |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Aging medicine.medical_specialty multimorbidity Clinical Sciences Pain Opioid Practice Patterns Nursing Opioid prescribing 03 medical and health sciences 0302 clinical medicine Older patients Clinical Research 030502 gerontology 80 and over Humans Pain Management Medicine Multimorbidity illness burden Practice Patterns Physicians' Intensive care medicine older adults General Nursing Aged Aged 80 and over Analgesics Physicians' business.industry Pain Research opioids Evaluation of treatments and therapeutic interventions Original Articles General Medicine Analgesics Opioid Anesthesiology and Pain Medicine 6.1 Pharmaceuticals 030220 oncology & carcinogenesis Public Health and Health Services Treatment strategy Female Chronic Pain 0305 other medical science business Gerontology hospitalization |
| Zdroj: | Journal of palliative medicine, vol 23, iss 4 J Palliat Med |
| ISSN: | 1557-7740 1096-6218 |
| DOI: | 10.1089/jpm.2019.0260 |
| Popis: | Background: Multimorbidity and pain are both common among older adults, yet pain treatment strategies for older patients with multimorbidity have not been well characterized. Objectives: To assess the prevalence and relationship between multimorbidity and opioid prescribing in hospitalized older medical patients with pain. Methods: We collected demographic, morbidity, pain, and analgesic treatment data through structured review of the electronic medical records of a consecutive sample of 238 medical patients, aged ≥65 years admitted between November 2014 and May 2015 with moderate-to-severe pain by numerical pain rating scale (range 4–10). We used the Cumulative Illness Rating Scale for Geriatrics (CIRS-G) to assess multimorbidity and cumulative illness burden. We examined the relationship between morbidity measures and opioid prescribing at hospital discharge using multivariate regression analysis. Results: The mean age was 75 ± 8 years, 57% were female and 50% were non-White. Mean CIRS-G total score was 17 ± 6, indicating high cumulative illness burden. Ninety-nine percent of patients had multimorbidity, defined as moderate-to-extremely severe morbidity in ≥2 organ systems. Sixty percent of patients received an opioid prescription at discharge. In multivariate analyses adjusted for age, race, and gender, patients with a discharge opioid prescription were significantly more likely to have higher cumulative illness burden and chronic pain. Conclusion: Among older medical inpatients, multimorbidity was nearly universal, and patients with higher cumulative illness burden were more likely to receive a discharge opioid prescription. More studies of benefits and harms of analgesic treatments in older adults with multimorbidity are needed to guide clinical practice. |
| Databáze: | OpenAIRE |
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