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. 2024 Oct;19(10):877-885.
doi: 10.1002/jhm.13408. Epub 2024 May 14.

New initiation of opioids, benzodiazepines and antipsychotics following hospitalization for COVID-19

Samantha Harrison  1   2 , Krystal Capers  1   2 , Guanqing Chen  1   2 , Ji T Liu  3 , Ameeka Pannu  1 , Valerie Goodspeed  1   2 , Akiva Leibowitz  1 , Somnath Bose  1   2
Affiliations

New initiation of opioids, benzodiazepines and antipsychotics following hospitalization for COVID-19

Samantha Harrison et al. J Hosp Med. 2024 Oct.

Abstract

Background: Patients newly initiated on opioids (OP), benzodiazepines (BZD), and antipsychotics (AP) during hospitalization are often prescribed these on discharge. Implications of this practice on outcomes remains unexplored.

Objective: To explore the prevalence and risk factors of new initiation of select OP, BZD and AP among patients requiring in-patient stays. Test the hypothesis that new prescriptions are associated with higher odds of readmission or death within 28 days of discharge.

Design: Single center retrospective cohort study.

Setting and participants: Patients admitted to a tertiary-level medical center with either a primary diagnosis of RT-PCR positive for COVID-19 or high index of clinical suspicion thereof.

Intervention: None.

Main outcome and measures: Exposure was the new initiation of select common OP, BZD, and AP which were continued on hospital discharge. Outcome was a composite of 28-day readmission or death following index admission. Multivariable logistic regression was used to assess patient mortality or readmission within 28 days of discharge associated with new prescriptions at discharge.

Results: 1319 patients were included in the analysis. 11.3% (149/1319) were discharged with a new prescription of select OP, BZD, or AP either alone or in combination. OP (110/149) were most prescribed followed by BZD (41/149) and AP (22/149). After adjusting for unbalanced confounders, new prescriptions (adjusted odds ratio: 2.44, 95% confidence interval: 1.42-4.12; p = .001) were associated with readmission or death within 28 days of discharge. One in nine patients admitted with a diagnosis of COVID-19 or high clinical suspicion thereof were discharged with a new prescription of either OP, BZD or AP. New prescriptions were associated with higher odds of 28-day readmission or death. Strengthening medication reconciliation processes focused on these classes may reduce avoidable harm.

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References

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