A Multimodal Intervention Using Nonopioid Analgesics Is Associated With Reduced Intravenous Opioid Exposure Among Hospitalized Patients With Inflammatory Bowel Diseases
INTRODUCTION: Opioid use in patients with inflammatory bowel disease (IBD) is associated with increased mortality. Previous interventions targeting reduced intravenous opioid (IVOPI) exposure for all patients admitted to a general medical unit have decreased total opioid use without compromising pain control. We therefore performed a prospective evaluation of a multimodal intervention encouraging the use of nonopioid alternatives to reduce IVOPI exposure among patients with IBD hospitalized at our institution.
METHODS: This was a prospective evaluation of a multimodal intervention to reduce IVOPI use among patients with IBD aged ≥18 years admitted to a general medical unit at a large urban academic medical center from January 1, 2019, to June 30, 2019. Intravenous and total (all routes) opioid exposures were measured as proportions and intravenous morphine milligram equivalents/patient day and compared with preintervention (January 1, 2018, to December 31, 2018) data. Hospital length of stay (LOS), 30-day readmission rates (RRs), and pain scores (1-10 scale) were also assessed.
RESULTS: Our study involved 345 patients with IBD with similar baseline characteristics in preintervention (n = 241) and intervention (n = 104) periods. Between study periods, we observed a significant reduction in the proportion of patients receiving IVOPIs (43.6% vs 30.8%, P = 0.03) and total opioid dose exposure (15.6 vs 8.5 intravenous morphine mg equivalents/d, P = 0.02). We observed similar mean pain scores (3.9 vs 3.7, P = 0.55) and significantly reduced mean LOS (7.2 vs 5.3 days, P = 0.03) and 30-day RRs (21.6% vs 11.5%, P = 0.03).
DISCUSSION: A multimodal intervention was associated with reduced opioid exposure, LOS, and 30-day RRs for hospitalized patients with IBD. Additional research is needed to determine long-term benefits of reduced opioid exposure in this population.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:115 |
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| Enthalten in: |
The American journal of gastroenterology - 115(2020), 9 vom: 01. Sept., Seite 1474-1485 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Dalal, Rahul S [VerfasserIn] |
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| Links: |
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| Themen: |
Analgesics, Non-Narcotic |
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| Anmerkungen: |
Date Completed 29.09.2020 Date Revised 16.07.2022 published: Print Citation Status MEDLINE |
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| doi: |
10.14309/ajg.0000000000000806 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM313708339 |
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| 100 | 1 | |a Dalal, Rahul S |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A Multimodal Intervention Using Nonopioid Analgesics Is Associated With Reduced Intravenous Opioid Exposure Among Hospitalized Patients With Inflammatory Bowel Diseases |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a INTRODUCTION: Opioid use in patients with inflammatory bowel disease (IBD) is associated with increased mortality. Previous interventions targeting reduced intravenous opioid (IVOPI) exposure for all patients admitted to a general medical unit have decreased total opioid use without compromising pain control. We therefore performed a prospective evaluation of a multimodal intervention encouraging the use of nonopioid alternatives to reduce IVOPI exposure among patients with IBD hospitalized at our institution | ||
| 520 | |a METHODS: This was a prospective evaluation of a multimodal intervention to reduce IVOPI use among patients with IBD aged ≥18 years admitted to a general medical unit at a large urban academic medical center from January 1, 2019, to June 30, 2019. Intravenous and total (all routes) opioid exposures were measured as proportions and intravenous morphine milligram equivalents/patient day and compared with preintervention (January 1, 2018, to December 31, 2018) data. Hospital length of stay (LOS), 30-day readmission rates (RRs), and pain scores (1-10 scale) were also assessed | ||
| 520 | |a RESULTS: Our study involved 345 patients with IBD with similar baseline characteristics in preintervention (n = 241) and intervention (n = 104) periods. Between study periods, we observed a significant reduction in the proportion of patients receiving IVOPIs (43.6% vs 30.8%, P = 0.03) and total opioid dose exposure (15.6 vs 8.5 intravenous morphine mg equivalents/d, P = 0.02). We observed similar mean pain scores (3.9 vs 3.7, P = 0.55) and significantly reduced mean LOS (7.2 vs 5.3 days, P = 0.03) and 30-day RRs (21.6% vs 11.5%, P = 0.03) | ||
| 520 | |a DISCUSSION: A multimodal intervention was associated with reduced opioid exposure, LOS, and 30-day RRs for hospitalized patients with IBD. Additional research is needed to determine long-term benefits of reduced opioid exposure in this population | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 7 | |a Analgesics, Non-Narcotic |2 NLM | |
| 650 | 7 | |a Analgesics, Opioid |2 NLM | |
| 700 | 1 | |a Palchaudhuri, Sonali |e verfasserin |4 aut | |
| 700 | 1 | |a Snider, Christopher K |e verfasserin |4 aut | |
| 700 | 1 | |a Gitelman, Yevgeniy |e verfasserin |4 aut | |
| 700 | 1 | |a Brahmbhatt, Mihir |e verfasserin |4 aut | |
| 700 | 1 | |a Mull, Nikhil K |e verfasserin |4 aut | |
| 700 | 1 | |a Mehta, Shivan J |e verfasserin |4 aut | |
| 700 | 1 | |a Klock, Christopher |e verfasserin |4 aut | |
| 700 | 1 | |a Lewis, James D |e verfasserin |4 aut | |
| 700 | 1 | |a Lichtenstein, Gary R |e verfasserin |4 aut | |
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