Long-acting opioid initiation in US nursing homes
dc.contributor.author | Hunnicutt, Jacob N. | |
dc.contributor.author | Hume, Anne L. | |
dc.contributor.author | Ulbricht, Christine M. | |
dc.contributor.author | Tjia, Jennifer | |
dc.contributor.author | Lapane, Kate L. | |
dc.date | 2022-08-11T08:10:35.000 | |
dc.date.accessioned | 2022-08-23T17:13:31Z | |
dc.date.available | 2022-08-23T17:13:31Z | |
dc.date.issued | 2018-06-04 | |
dc.date.submitted | 2018-08-16 | |
dc.identifier.citation | <p>Pharmacoepidemiol Drug Saf. 2018 Jun 4. doi: 10.1002/pds.4568. [Epub ahead of print] <a href="https://doi.org/10.1002/pds.4568">Link to article on publisher's site</a></p> | |
dc.identifier.issn | 1053-8569 (Linking) | |
dc.identifier.doi | 10.1002/pds.4568 | |
dc.identifier.pmid | 29869441 | |
dc.identifier.uri | http://hdl.handle.net/20.500.14038/46745 | |
dc.description.abstract | PURPOSE: To estimate the proportion of residents newly initiating long-acting opioids in comparison to residents initiating short-acting opioids and examine variation in long-acting opioid initiation by region and resident characteristics. METHODS: This cross-sectional study included 182 735 long-stay nursing home residents in 13 881 US nursing homes who were Medicare beneficiaries during 2011 to 2013 and initiated a short-acting or long-acting opioid (excluding residents < 50 years old, those with cancer, or receiving hospice care). Medicare Part D prescription claims were used to identify residents as newly initiating short-acting or long-acting opioids, defined as having a prescription claim for an opioid with no prior opioid prescriptions in the preceding 60 days. We estimated the overall proportion of initiators prescribed long-acting opioids. Regional variation was examined by mapping results by state and hospital referral regions. Logistic models were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). RESULTS: Two percent of opioid initiators were prescribed long-acting opioids. State variation in long-acting opioid initiation ranged from 0.6% to 7.5% (5th-95th percentiles: 0.6-6.4%). Resident characteristics associated with increased long-acting opioid initiation included severe physical limitations (vs none/mild limitations; aOR: 2.13, 95% CI: 1.92-2.37) and pain (staff-assessed vs no pain; aOR: 1.59 95% CI: 1.40-1.80), whereas being non-White was inversely associated (non-Hispanic black vs non-Hispanic white; aOR: 0.70, 95% CI: 0.62-0.79). CONCLUSION: United States nursing home residents predominantly initiate short-acting opioids in accordance with Center for Disease Control and Prevention guidelines. Documented variation by geographic and resident characteristics suggests that improvements are possible. | |
dc.language.iso | en_US | |
dc.relation | <p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=29869441&dopt=Abstract">Link to Article in PubMed</a></p> | |
dc.relation.url | https://doi.org/10.1002/pds.4568 | |
dc.subject | long-acting opioids | |
dc.subject | long-term care | |
dc.subject | nursing homes | |
dc.subject | pharmacoepidemiology | |
dc.subject | prescription opioids | |
dc.subject | Epidemiology | |
dc.subject | Geriatrics | |
dc.subject | Health Services Administration | |
dc.subject | Health Services Research | |
dc.subject | Medical Pharmacology | |
dc.subject | Pharmaceutical Preparations | |
dc.subject | Pharmacy and Pharmaceutical Sciences | |
dc.subject | Therapeutics | |
dc.title | Long-acting opioid initiation in US nursing homes | |
dc.type | Journal Article | |
dc.source.journaltitle | Pharmacoepidemiology and drug safety | |
dc.identifier.legacycoverpage | https://escholarship.umassmed.edu/qhs_pp/1205 | |
dc.identifier.contextkey | 12670999 | |
html.description.abstract | <p>PURPOSE: To estimate the proportion of residents newly initiating long-acting opioids in comparison to residents initiating short-acting opioids and examine variation in long-acting opioid initiation by region and resident characteristics.</p> <p>METHODS: This cross-sectional study included 182 735 long-stay nursing home residents in 13 881 US nursing homes who were Medicare beneficiaries during 2011 to 2013 and initiated a short-acting or long-acting opioid (excluding residents < 50 years old, those with cancer, or receiving hospice care). Medicare Part D prescription claims were used to identify residents as newly initiating short-acting or long-acting opioids, defined as having a prescription claim for an opioid with no prior opioid prescriptions in the preceding 60 days. We estimated the overall proportion of initiators prescribed long-acting opioids. Regional variation was examined by mapping results by state and hospital referral regions. Logistic models were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).</p> <p>RESULTS: Two percent of opioid initiators were prescribed long-acting opioids. State variation in long-acting opioid initiation ranged from 0.6% to 7.5% (5th-95th percentiles: 0.6-6.4%). Resident characteristics associated with increased long-acting opioid initiation included severe physical limitations (vs none/mild limitations; aOR: 2.13, 95% CI: 1.92-2.37) and pain (staff-assessed vs no pain; aOR: 1.59 95% CI: 1.40-1.80), whereas being non-White was inversely associated (non-Hispanic black vs non-Hispanic white; aOR: 0.70, 95% CI: 0.62-0.79).</p> <p>CONCLUSION: United States nursing home residents predominantly initiate short-acting opioids in accordance with Center for Disease Control and Prevention guidelines. Documented variation by geographic and resident characteristics suggests that improvements are possible.</p> | |
dc.identifier.submissionpath | qhs_pp/1205 | |
dc.contributor.department | Department of Quantitative Health Sciences |