Nonopioid analgesic use in older patients admitted for orthopedic rehabilitation.
Aaron J Bilek, Stephanie Cullen, Carolyn M Tan and 3 others
PMID 38847115WHAT IT FOUND
Older patients in orthopedic rehab who received nonopioid pain meds were younger, had higher BMI, and prior opioid use.
They got higher opioid doses than those who did not receive nonopioids, suggesting these drugs were not used to spare opioids.
Key findings
01Patients receiving nonopioid analgesics had significantly higher average opioid doses (13.7 vs 6.1 mg/day oral morphine equivalents) than those who did not.
02Use of nonopioid analgesics declined with age, from 65.3% in the youngest group (50–64) to 33.5% in the oldest (85+).
03Prior use of nonopioid analgesics at home was the strongest independent predictor of receiving them during rehab, with an odds ratio of 3.15.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study is retrospective and single-center, limiting generalizability and preventing causal conclusions. Data on outpatient prescriptions and medications administered during the acute hospital stay prior to rehab admission were not accessible. The definition of nonopioid analgesic use excluded acetaminophen, which may not reflect real-world multimodal pain management. Selection bias is likely, as younger and elective surgery patients were more likely to receive nonopioid analgesics. The short duration of nonopioid analgesic use during the stay may have limited the ability to detect adverse events.
Declared interests
None reported.
The easy way to misread this
Do not assume that prescribing nonopioid analgesics in this setting leads to reduced opioid use. In this study, patients who received nonopioids actually consumed more opioids than those who did not, indicating that these medications were not being used for an opioid-sparing effect.