A prospective pilot study showed that pain care for patients already taking opioids can be improved by utilizing multiple nonopioid treatments during hospitalization. This approach can also lower readmission rates.
The study's principal concern is the traditionally high hospital readmission rates for patients with a strong tolerance for opioids due to the medicinal treatment of chronic pain. When these patients arrive at hospitals for surgeries, they are at high risk for suffering acute pain. They are in need of alternative treatment plans that do not involve opioid doses.
David A. Edwards, MD, PhD, clinical chief of pain at Vanderbilt University Medical Center in Nashville, Tenn., was the lead author of the study. "The transition from in-hospital to out-of-hospital is where the problem lies," Dr. Edwards said. "Clinicians need to know what they can offer patients other than opioids to treat pain and suffering, especially when the patients arrive on high-dose opioids already."
The study found that as the use of multimodal medical analgesia increased, the length of patient's hospital stay and the quantity of opioid doses dropped. The readmission rate was 28 percent for the 18 opioid-tolerant patients who received alternative, nonopioid care in the pilot study. The readmission rate amongst patients receiving traditional care was 40 percent.
Authors of the study want to move forward with a randomized controlled trial at Vanderbilt University Medical Center and Massachusetts General Hospital and Brigham and Women's
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