Patient and medication-related factors associated with opioid use disorder after inpatient opioid administration

Background Examine baseline factors associated with a new diagnosis of opioid use disorder (OUD) within 12 months postdischarge among opioid-naive patients who received an opioid prescription in the inpatient setting. Design/Setting Retrospective cohort (surgery and nonsurgery) study of opioid-naive patients who had at least one prescription for an opioid during an inpatient hospitalist between 2014 and 2017. Participants Twenty-three thousand and thirty-three patients were included. Objective The primary objective was to determine baseline factors associated with a new OUD diagnosis within 12 months of discharge. Baseline covariates included demographic information, clinical characteristics, medication use, characteristics related to index hospital encounter, and discharge location. Findings 2.1% of the sample had a new diagnosis of OUD within a year after receiving an opioid during hospital admission. Patients between ages 25 and 34 had higher odds of a new OUD diagnosis compared to those 65 years of age and older (odds ratio [OR]: 6.98, 95% confidence interval [CI]: 4.02-12.1 [nonsurgery] and 4.69, 95% CI: 2.63-8.37 [surgery]). Patients from a high opioid geo-rank region had higher odds of OUD diagnosis (OR: 2.08, 95% CI: 1.31-3.31 [nonsurgery] and 1.80, 95% CI: 1.03-3.15 [surgery]). History of nonopioid-related drug disorder, tobacco use disorder, mental health conditions, and gabapentin use 12 months prior to index date and white race were associated with higher odds of new OUD diagnosis. Conclusions It is important to identify and evaluate factors associated with developing a new diagnosis of OUD following hospitalization. This can inform pain management strategies within the hospital and at discharge, and prompt clinicians to screen for risk of OUD.

Automated summary

This study aimed to investigate and analyze the factors associated with a new diagnosis of opioid use disorder (OUD) following hospitalization. The study found that patients between the ages of 25 to 34 who received opioids during their hospital stay, as well as those from regions with a high opioid ranking, had a higher likelihood of developing a new diagnosis of OUD. In addition, patients with a history of nonopioid-related drug disorders, tobacco use disorders, mental health conditions, gabapentin use within the previous 12 months, and those of white race also had a higher risk of new OUD diagnosis.