Multimodal intervention cuts opioid exposure in hospitalized IBD patients
A multimodal intervention using nonopioid analgesics results in reduced intravenous opioid (IVOPI) exposure, length of stay (LOS), and 30-day readmission rates for hospitalized patients with inflammatory bowel disease (IBD), a study has shown.
The investigators performed a prospective evaluation of a multimodal intervention to reduce IVOPI use among patients with IBD aged ≥18 years admitted to a general medical unit at a large urban academic medical centre from 1 January 2019 to 30 June 2019.
They measured IV and total (all routes) opioid exposures as proportions and IV morphine milligram equivalents/patient day and compared with preintervention data. Hospital LOS, 30-day readmission rates, and pain scores were also evaluated.
Overall, 345 patients with IBD were included. Baseline characteristic were similar between preintervention (n=241) and intervention (n=104) periods. A significant reduction was observed in the proportion of patients receiving IVOPIs (43.6 percent vs 30.8 percent; p=0.03) and total opioid dose exposure (15.6 vs 8.5 IV morphine mg equivalents/day; p=0.02) between study periods.
Furthermore, mean pain scores (3.9 vs 3.7; p=0.55) were similar, while mean LOS (7.2 vs 5.3 days; p=0.03) and 30-day readmission rates (21.6 percent vs 11.5 percent; p=0.03) were significantly reduced.
Further research is warranted to determine the long-term benefits of reduced opioid exposure in this population, according to the investigators.
“Opioid use in patients with IBD is associated with increased mortality,” they said. “Previous interventions targeting reduced IVOPI exposure for all patients admitted to a general medical unit have decreased total opioid use without compromising pain control.”