@article{15460,
  author = {Niki M Krancevich and Julie J Belfer and Heather M Draper and Kyle J Schmidt},
  title = {Impact of opioid administration in the intensive care unit and subsequent use in opioid-naïve patients},
  abstract = {<jats:sec><jats:title>Background</jats:title><jats:p> Opioids are a mainstay of therapy for patients in the intensive care unit (ICU) as part of the analgesia-first approach to sedation. Despite knowledge of acute consequences of opioid based analgosedation, less is known about the potential long-term consequences, including the effect of opioid administration in the ICU on subsequent opioid use in opioid-naïve patients. </jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p> To evaluate the relationship between ICU opioid administration to opioid-naïve patients and subsequent opioid use following discharge. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> A query of the electronic medical record was performed to identify opioid-naïve adult patients admitted directly to an ICU. Patients who received continuous intravenous infusion of fentanyl, hydromorphone, or morphine were screened for inclusion into the analysis. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Of the 342 patients included for analysis, 164 (47.1%) received an opioid at hospital discharge. In total, 17 of the 342 patients (5.0%) became long-term users, noted to be more common in patients who received an opioid prescription at discharge (8.7% vs 1.6%; P = 0.006). Neither total ICU morphine milligram equivalent (MME) nor average daily ICU MME administration were found to correlate with daily MME prescription quantity at discharge ( R<jats:sup>2</jats:sup> = 0.008 and R<jats:sup>2</jats:sup> = 0.03, respectively). Following control for potentially confounding variables, total ICU MME administration remained an insignificant predictor of subsequent receipt of an opioid prescription at discharge and long-term opioid use. </jats:p></jats:sec><jats:sec><jats:title>Conclusion and Relevance</jats:title><jats:p> This study failed to find a significant relationship between ICU opioid use in opioid-naïve patients and subsequent opioid use. These findings highlight the need to focus on transitions points between the ICU and discharge as potential opportunities to reduce inappropriate opioid continuation. </jats:p></jats:sec>},
  year = {2022},
  journal = {Ann Pharmacother},
  volume = {56},
  pages = {52-59},
  month = {05/2021},
  publisher = {SAGE Publications},
  issn = {1060-0280},
  doi = {10.1177/10600280211016856},
}