New Initiation of Long-Acting Opioids in Long-Stay Nursing Home Residents

作者：Pimentel Camilla B; Gurwitz Jerry H; Tjia Jennifer; Hume Anne L; Lapane Kate L^*

来源：Journal of the American Geriatrics Society, 2016, 64(9): 1772-1778.

DOI：10.1111/jgs.14306

• nursing home
• long-acting opioid
• analgesics

OBJECTIVES: To estimate the prevalence of new initiation of long-acting opioids since introduction of national efforts to increase prescriber and public awareness on safe use of transdermal fentanyl patches.
DESIGN: Cross-sectional.
SETTING: U.S. nursing homes (NHs).
PARTICIPANTS: Medicare-enrolled long-stay NH residents (N = 22,253).
MEASUREMENTS: Minimum Data Set 3.0 was linked with Medicare enrollment, hospital claims, and prescription drug transaction data (January-December 2011) and used to determine the prevalence of new initiation of a long-acting opioid prescribed to residents in NHs.
RESULTS: Of NH residents prescribed a long-acting opioid within 30 days of NH admission (n = 12,278), 9.4% (95% confidence interval = 8.9-9.9%) lacked a prescription drug claim for a short-acting opioid in the previous 60 days. The most common initial prescriptions of long-acting opioids were fentanyl patch (51.9% of opioid-naive NH residents), morphine sulfate (28.1%), and oxycodone (17.2%).
CONCLUSION: New initiation of long-acting opioids-especially fentanyl patches, which have been the subject of safety communications-persists in NHs.

• 出版日期2016-9