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New Initiation of Long‐Acting Opioids in Long‐Stay Nursing Home Residents
Author(s) -
Pimentel Camilla B.,
Gurwitz Jerry H.,
Tjia Jennifer,
Hume Anne L.,
Lapane Kate L.
Publication year - 2016
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.14306
Subject(s) - medicine , nursing homes , nursing , medline , gerontology , political science , law
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 ( NH s). 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 NH s. 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 NH s.