The Effect of Reducing Intravenous Push Opioid Use on Hospital Medicine Patients’ Pain Experience during Hospitalization

Link to article at PubMed

Pain Med. 2021 Jun 26:pnab205. doi: 10.1093/pm/pnab205. Online ahead of print.


OBJECTIVE: To determine the efficacy of a program to limit the use of the IV push route for opioids on the experience of pain by inpatients and on associated safety events.

DESIGN: Retrospective cohort study.

SETTING: Two inpatient general medicine floor units at an urban tertiary care academic medical center.

SUBJECTS: 4752 inpatient opioid recipients.

METHODS: Patients on one unit were exposed to a multidisciplinary intervention to limit prescription of opioids via the IV push route, with the other unit used as a control unit. The primary study outcome was mean numeric pain score per patient during the hospital stay. Secondary measures included hospital length of stay and post-discharge patient satisfaction. Fidelity measures included percentage of patient population exposed to each opioid administration route and amount of opioid administered per route. Safety measures included patient disposition, transfer to intensive care, and incidence of naloxone administration.

RESULTS: The intervention was successful in decreasing both percentage of patients exposed to IV push opioids and amount of opioid administered via the IV push route, but no associated changes in other study outcomes were identified.

CONCLUSIONS: For treatment of acute pain in medical inpatients, no evidence of benefit or harm was identified in relation to increase or decrease in use of the IV push opioid route.

PMID:34181019 | DOI:10.1093/pm/pnab205

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