Are Opioid-Naive Patients With Acute Pancreatitis Given Opioid Prescriptions at Discharge?

Overview

OBJECTIVES: Opioids are commonly used in the management of acute pancreatitis (AP). Inpatient opioid exposure is known to increase the risk of chronic opioid use after discharge. Prescription patterns for opioids at discharge for AP are unknown. METHODS: Medical records of adult AP patients who presented to the emergency department from September 1, 2013, to August 31, 2016, were reviewed. Opioid prescription at discharge was defined as a prescription for opioids in a patient who was opioid naive at admission. Multivariable logistic regression was performed to identify predictors of opioid prescription at discharge. RESULTS: A total of 259 opioid-naive AP patients were identified. Of these, 108 (41.6%) of 259 were discharged with an opioid prescription and 61 (56.5%) of 108 had discharge pain scores of 3 or lower. Two hundred twenty-two (85.7%) received opioids during admission and 105 (47.3%) of 222 were discharged with an opioid prescription. On multivariable analysis, predictors of discharge opioid prescription included inpatient use of opioids, female sex, and discharge pain score greater than 3. CONCLUSIONS: In opioid-naive AP patients, 41.6% were discharged from the hospital with a new prescription for opioids, even though a significant proportion had pain scores of 3 or lower. Guidelines are needed for opioid prescriptions at discharge for AP.