• Marisha Burden, Angela Keniston, Mary Anderson Wallace, Jason W Busse, Jordi Casademont, Smitha R Chadaga, Sumitra Chandrasekaran, Marco Cicardi, John M Cunningham, David Filella, Daniel Hoody, David Hilden, Ming-Ju Hsieh, Yoon-Seon Lee, Daniel D Melley, Anna Munoa, Francesca Perego, Chin-Chung Shu, Chang Hwan Sohn, Jeffrey Spence, Lindsay Thurman, Cindy R Towns, John You, Luca Zocchi, and Richard K Albert.
• Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado.
• J Hosp Med. 2019 Dec 1; 14 (12): 737-745.

BackgroundHospitalized patients are frequently treated with opioids for pain control, and receipt of opioids at hospital discharge may increase the risk of future chronic opioid use.ObjectiveTo compare inpatient analgesic prescribing patterns and patients' perception of pain control in the United States and non-US hospitals.DesignCross-sectional observational study.SettingFour hospitals in the US and seven in seven other countries.ParticipantsMedical inpatients reporting pain.MeasurementsOpioid analgesics dispensed during the first 24-36 hours of hospitalization and at discharge; assessments and beliefs about pain.ResultsWe acquired completed surveys for 981 patients, 503 of 719 patients in the US and 478 of 590 patients in other countries. After adjusting for confounding factors, we found that more US patients were given opioids during their hospitalization compared with patients in other countries, regardless of whether they did or did not report taking opioids prior to admission (92% vs 70% and 71% vs 41%, respectively; P < .05), and similar trends were seen for opioids prescribed at discharge. Patient satisfaction, beliefs, and expectations about pain control differed between patients in the US and other sites.LimitationsLimited number of sites and patients/country.ConclusionsIn the hospitals we sampled, our data suggest that physicians in the US may prescribe opioids more frequently during patients' hospitalizations and at discharge than their colleagues in other countries, and patients have different beliefs and expectations about pain control. Efforts to curb the opioid epidemic likely need to include addressing inpatient analgesic prescribing practices and patients' expectations regarding pain control.

40 keywords...

hide…