Comparison of Patient-Reported Hospital Discharge Experiences in Patients with Long-Term and Episodic Opioid Therapy: A Qualitative Study.

backgroundChallenges and unmet needs during care transitions may contribute to the initiation and continuation of long-term opioid therapy (LTOT), potentially leading to adverse patient outcomes and increased strain on the healthcare system. This study explored and compared patient-reported hospital discharge experiences among individuals who developed LTOT within 1-year post-discharge and episodic opioid users (EOU).

methodsA cohort of patients discharged from participating study hospitals in Montreal (Canada) between October 2014 and November 2016 was assembled. Qualitative analysis of patients' telephone interviews conducted 30 days post-discharge was used to characterize hospital discharge experiences among EOU and LTOT patients. An empirically derived definition of 60 days of cumulative opioid use, measured using pharmacy administrative claims from the provincial universal healthcare program, was used to define LTOT.

resultsAmong the 1511 patients in the cohort, 22.4% were classified as LTOT and 29.2% reported experiencing challenges related to their hospital discharge. The most common challenges included a lack of (1) communication of information on medication regimens and post-discharge follow-up care, (2) clarity or appropriateness of medical information at discharge, (3) hospital discharge planning, (4) coordination of care among team members, and (5) monitoring and management of symptoms post-discharge. LTOT patients were also more likely to express concerns about hospital discharge planning processes such as early or rushed discharge compared with EOU (18.0% vs 13.4%).

conclusionsThis study used patient-reported interview data to explore how in-hospital and post-discharge experiences may differ between patients who went on to develop long-term versus episodic opioid use patterns. Our results highlight areas that may warrant further investigation and could inform the design of future interventions to support safer transitions in care and improved continuity of care.