ArticleThe western journal of emergency medicine2018
Opioid Administration and Prescribing in Older Adults in U.S. Emergency Departments (2005-2015).
Article in The western journal of emergency medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
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- Opioids in geriatric units in 14 Belgian hospitals: prevalence, dosage and associated factors.Annals of medicine · 2024Article
- Short-term outcomes of prehospital opioid pain management for older adults with fall-related injury.Journal of the American Geriatrics Society · 2024Article
- Influences of Software Changes on Oxycodone Prescribing at an Australian Tertiary Emergency Department: A Retrospective Review.Pharmacy (Basel, Switzerland) · 2024Article
- Racial Disparities in Opioid Administration Practices Among Undifferentiated Abdominal Pain Patients in the Emergency Department.Journal of racial and ethnic health disparities · 2024Article
- Article
- Assessing local California trends in emergency physician opioid prescriptions from 2012 to 2020: Experiences in a large academic health system.The American journal of emergency medicine · 2022Article
- Trends and risk factors for opioid administration for non-emergent lower back pain.World journal of orthopedics · 2021Article
- Leftover narcotic analgesics among emergency department patients and methods of disposal.Journal of the American College of Emergency Physicians open · 2020Article
- Temporal Factors Associated With Opioid Prescriptions for Patients With Pain Conditions in an Urban Emergency Department.JAMA network open · 2020Article
- The Association Between Patient Visit Demographics and Opioid Analgesic Received in the Emergency Department.Cureus · 2019Article
- A novel Project ECHO curriculum on older adult pain management and opioid use disorder for outpatient clinicians.Gerontology & geriatrics educationArticle
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionWe assess trends in opioid administration and prescribing from 2005-2015 in older adults in United States (U.S.) emergency departments (ED).
methodsWe analyzed data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) survey from 2005 to 2015. ED visits for painful conditions were selected and stratified by age (18-64, 65-74, 75-84, ≥ 85 years). We analyzed trends in opioid administration in the ED and prescribing at discharge to encounters ≥ 65 and assessed predictors of use using survey-weighted chi-square tests and logistic regression. Trends in the use of five commonly prescribed opioids were also explored.
resultsOpioid administration in the ED and prescribing at discharge for encounters with patients ≥ 65 years fell overall, but not significantly. By contrast, opioid administration in the ED and prescribing at discharge significantly declined for adult encounters 18-64 by 20% and 32%, respectively. A similar proportion of adult encounters ≥ 65 were administered opioids in the ED as 18-64, but adult encounters ≥ 85 had the lowest rates of administration. A smaller proportion of adult encounters ≥ 65 years with painful conditions were prescribed opioids at discharge compared to <65. However, this age-related disparity in prescribing narrowed over the study period. There were shifts in the specific types of opioids administered and prescribed in adult encounters ≥ 65 years over the study period, with the most notable being a 76% increase in hydromorphone administration comparing 2005-06 to 2014-15.
conclusionFrom 2005-15, 1 in 4 to 1 in 10 ED patients with painful conditions were administered or prescribed an opioid in U.S. EDs. Opioids prescribing increased from 2005-11 and then declined from 2012-15, more so among visits in the 18-64 age group compared to ≥ 65 years. Opioid administrating demonstrated a gradual rise and decline in all adult age groups. Age consistently appears to be an important consideration, where opioid prescribing declines with advancing age. Given the nationwide opioid crisis, ED providers should remain vigilant in limiting opioids, particularly in older adults who are at higher risk for adverse effects.
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