Effect of Alternatives to Opiates Program on Discharge Opioid Prescribing in Trauma Patients
Document Type
Article
Publication Date
8-1-2024
Abstract
Background: Opioid overdose deaths have increased over the last two decades, despite efforts to reduce prescribing. This study aimed to determine if a hospital-wide Alternatives to Opiates (ALTOSM) program reduced opioid prescribing in hospital and upon discharge after trauma. Objectives: The primary outcome was incidence of opioid prescribing at hospital discharge Pre- and Post-ALTO. Secondary outcomes were the percent of patients with in-hospital opioid, non-opioid and multimodal analgesia, and hospital and intensive care unit (ICU) length of stay (LOS). Methods: This is a single-center, retrospective analysis of patients >/ = 18 years old admitted for >24 hours with the primary diagnosis of traumatic injury between August 2018 - October 2019. Patients with alcohol or polysubstance abuse, chronic opioid use, or in-hospital mortality were excluded. Results: A total of 703 patients were included, 471 in Pre-ALTO and 232 in Post-ALTO groups. The mean age was 59 ± 22 years and most were male (58.7%). Mean initial Injury Severity Score (ISS) was 9.1 ± 7.7. Opioid prescribing at hospital discharge occurred more in the Post-ALTO group (132/332, 39.4% vs 90/203, 43.8%; P =.1237). Most patients were prescribed in-hospital opioid (332/471, 70.4% vs 203/232, 87.5%, P <.0001) and non-opioid (441/471, 93.6% vs 229/232, 98.7%; P =.0027) analgesics, or multimodal analgesia (397/471, 84.3% vs 203/232, 87.5%; P =.2591). Median hospital and ICU LOS were also similar between groups [5 (3-9) vs 4(3-7), P =.3427] and ICU [2(0-4) vs 3(2-5), P =.3461]. Conclusion: Opioids remain mainstay for trauma-related pain treatment. ALTOSM was not associated with less in-hospital or discharge opioid prescribing.
Identifier
85165269425 (Scopus)
Publication Title
Journal of Pharmacy Practice
External Full Text Location
https://doi.org/10.1177/08971900231189353
e-ISSN
15311937
ISSN
08971900
PubMed ID
37438883
First Page
854
Last Page
861
Issue
4
Volume
37
Recommended Citation
Nerenberg, Steven F.; Kulig, Caitlin E.; LaPietra, Alexis M.; Elsawy, Osama A.; Wang, Antai; Foran, Lindsey A.; Hlayhel, Ahmad F.; Yang, James; Parmar, Dinesh; and Rowe, Jackie P., "Effect of Alternatives to Opiates Program on Discharge Opioid Prescribing in Trauma Patients" (2024). Faculty Publications. 270.
https://digitalcommons.njit.edu/fac_pubs/270
