Opioid Prescribing in Opioid-Naïve and Opioid-Exposed Mechanically Ventilated Medically Critically Ill Patients

Abstract

Objective:

Characterize opioid prescribing patterns in the ICU and post-hospital discharge in invasively mechanically ventilated (IMV) opioid-naïve and opioid-exposed patients.

Design:

Single-center, retrospective cohort study.

Setting:

Tertiary academic medical center.

Patients, participants:

Patients requiring IMV admitted to the MICU.

Interventions:

None.

Main outcomes measure(s):

Difference in opioid prescriptions at discharge from the hospital and opioid use during IMV between groups.

Results:

A total of 85 patients were included, 60 (70.6%) were opioid-naïve and 25 (29.4%) were opioid-exposed prior to admission. Five (8.3%) opioid-naïve and 16 (64.0%) opioid-exposed were prescribed opioids on discharge (P < 0.001). Median morphine milligram equivalents (MME) per day during IMV did not differ between groups.

Conclusions:

Although opioid discharge prescribing was relatively uncommon among medical ICU patients who were opioid-naïve prior to admission, areas to evaluate and optimize opioid prescribing during IMV and at discharge were identified.