Out of Eight Countries, US Patients Were Most Likely to Receive Opioid Medications During Hospitalization and at Discharge

Receipt of opioid medications during hospitalization may be a risk factor for long-term use of prescription opioids, which can lead to poor health outcomes in some patients. This cross-sectional survey of 981 adult patients in the US and 7 other countries compared receipt of opioid medication during hospitalization and patients’ perception of analgesic benefits. Patients were included if they reported pain within the first 24–36 hours of hospitalization.

Satisfaction with hospital pain management did not differ between patients in the US or other countries. Compared with patients in non-US countries (n=478), patients in the US (n=503) were more likely to:

• Have a history of “illicit drug use” (33% in US patients versus 6% in all others) and psychiatric illness (27% versus 8%).
• Receive opioid medications prior to hospitalization (38% versus 17%).
• Report greater pain severity.
• Receive opioid medications during hospitalization whether they were prescribed opioids prior to hospitalization (adjusted odds ratio [aOR], 3.2) or not (aOR, 2.8) and at higher doses.
• Have opioid medications prescribed at hospital discharge.

Comments: This study provides evidence that patients who are hospitalized in the US report higher pain severity and are more likely to receive opioid medications during hospitalization and at hospital discharge compared with patients from other countries. Although receipt of opioids during hospitalization can increase the risk of ongoing and unhealthy opioid use long-term, this must be balanced with the need for adequate analgesia in hospitalized patients.

Melissa Weimer, DO, MCR

Reference: Burden M, Keniston A, Wallace MA, et al. Opioid utilization and perception of pain control in hospitalized patients: a cross-sectional study of 11 sites in 8 countries. J Hosp Med. 2019;14(12):737–745.