New Initiation of Long-Acting Opioids in Long-Stay Nursing Home Residents
Date of Original Version
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-naïve 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.
Journal of the American Geriatrics Society
Pimentel, Camilla B., Jerry H. Gurwitz, Jennifer Tjia, Anne L. Hume, and Kate L. Lapane. "New Initiation of Long-Acting Opioids in Long-Stay Nursing Home Residents." Journal of the American Geriatrics Society 64, 9 (2016): 1772-1778. doi:10.1111/jgs.14306.