Opioids are commonly prescribed for acute gout management following discharge from the emergency department (ED), according to the results of a recently published retrospective cohort study.
In order to investigate opioid prescribing among gout patients in the ED, study authors analyzed data from the Lifespan electronic health records system to assess the frequency in which these patients received opioids, as well as the dose and duration of therapy. “Using multivariable logistic regression, we ascertained the factors associated with increased odds of opioid prescription at discharge among patients with acute gout,” the study authors explained.
The study authors reported that 28.3% (129/456) of patients included in the study received an opioid prescription upon discharge from the ED. Moreover, 79% (102/129) of patients who received an opioid prescription at discharge were not taking an opioid medication prior to their ED presentation. The mostly commonly prescribed opioid was reported to be oxycodone.
Results also showed that the average dose of opioid prescribed at discharge was 37.9±17.2mg of morphine equivalent; median duration was 8 days (interquartile range: 5, 14). In addition, patients who experienced a polyarticular gout attack, had diabetes, and those who utilized opioids prior to hospital admission were more likely to receive an opioid prescription at discharge.
“Our study suggests a high use of prescription opioid in patients discharged from the ED with a diagnosis of gout, a condition which can be managed effectively with other medications,” the study authors concluded. They added, “In addition to regulatory changes, the burden of opioid prescription could be potentially reduced by creating prompts for providers in electronic record system to avoid prescribing opioids in opioid-naïve patients OR using lower intensity and shorter duration of prescription.”
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