Patients hospitalized with acute coronary syndrome or acute decompensated heart failure who are prescribed opioid medication at discharge may be less likely to resort to planned healthcare use, according to a study published in the Journal of the American Heart Association.
The study included participants from the Vanderbilt Inpatient Cohort Study (VICS) who visited the Vanderbilt University Medical Center and had an admitting diagnosis of acute coronary syndrome and/or acute decompensated heart failure between October 2011 and December 2015 (n=2495). The primary outcome was unplanned healthcare use, including emergency department presentation or readmission. Secondary outcomes included mortality, cardiac rehabilitation, and provider follow-up within 30 days.
A total of 501 participants (20%) were discharged with an opioid prescription. These participants were predominantly white and men, with a median age of 59 years. No association was established between opioid prescription at discharge and increased unplanned healthcare use (adjusted hazard ratio, 1.06; 95% CI, 0.87-1.28) or mortality (adjusted hazard ratio, 1.08; 95% CI, 0.84-1.39). Participants discharged with vs without an opioid prescription were found to be less likely to complete planned healthcare use (adjusted odds ratio, 0.69; 95% CI, 0.52-0.91).
“In addition to the national focus on opioid-related overdose and mortality, it is imperative to understand how opioid use can affect a patient’s relationship with the healthcare system,” the researchers wrote.
Liberman JS, Samuels LR, Goggins K, et al. Opioid prescriptions at hospital discharge are associated with more postdischarge healthcare utilization [published online January 28, 2019]. J Am Heart Assoc. doi: 10.1161/JAHA.118.010664