Prevalence of and Factors Related to Prescription Opioids, Benzodiazepines, and Hypnotics Among Medicare Home Health Recipients.
Brandi P Cotton, Matthew C Lohman, Jessica M Brooks and 4 others
PMID 28562400WHAT IT FOUND
Most older adults starting Medicare home health care have a controlled medication, especially opioids.
Nurses should review the medication list at start-of-care, assess pain, depression, falls, and misuse risk, and provide education.
Key findings
01At start of care, 58% of patients had at least one controlled medication: 44% opioid, 19% benzodiazepine, and almost 7% non-benzodiazepine hypnotic.
02Use of opioids, benzodiazepines, and hypnotics was highest among patients reporting severe pain.
03Clinically meaningful depressive symptoms were associated with greater likelihood of any controlled medication and specifically benzodiazepine or hypnotic use.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study did not compare dosage strength or short versus long-acting opioids, benzodiazepines, or non-benzodiazepine hypnotics. The indication for each medication could not be determined from the data. Regional analysis was limited by fewer patients in the West. The analysis used start-of-care records and reports associations, not medication appropriateness, causation, or patient outcomes.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that these medications are inappropriate or that nurses should discontinue them. The study reports associations from start-of-care records and did not assess dosage, indication, or outcomes.