Characterizing Opioid-related Adverse Events in Older Adults After Hospital Discharge
Characterizing Opioid-related Adverse Events in Older Adults After Hospital Discharge
批准号:
10439612
负责人:
Shoshana J Herzig
金额:
$34.73万
依托单位国家:
美国
项目类别:
财政年份:
2018
资助国家:
美国
项目状态:
已结题
起止时间:
2018-09-01 至 2024-06-30
中文摘要
项目总结/文摘
英文摘要
PROJECT SUMMARY/ABSTRACT
For the more than 12 million adults age 65 and older hospitalized each year in the United States (U.S.), the
transition out of the hospital is an exceptionally vulnerable time in the care continuum. Post-discharge adverse
events are common, and medications are the leading cause of such adverse events, which disproportionately
affect older adults owing to greater degrees of comorbidity and polypharmacy, as well as altered
pharmacokinetics and pharmacodynamics of drugs. Opioids in particular are consistently among the top
medication classes to cause post-discharge adverse drug events (ADEs), and are prescribed to millions of
older adults after hospital discharge each year. However, the specific nature of post-discharge opioid-related
ADEs and patient- and prescribing-related predictors of such events have not been characterized. The broad
goal of the proposed work is to address this knowledge gap by defining the incidence, characteristics, and
predictors of post-discharge opioid-related ADEs in older adults. Such knowledge is crucial as a prelude to
developing successful, targeted interventions to reduce the adverse consequences of opioid use, particularly
for older adults during this highly vulnerable window of care. The Specific Aims of this proposal are:
1) To define the incidence and predictors of adverse events within 30 days of hospital discharge among older
adults with an opioid claim in the week after discharge using a large national dataset. Using claims data from
Medicare (the largest insurer for U.S. adults age 65+), we will determine the incidence and patient- and
prescribing-related risk factors for post-discharge adverse events among older adults discharged on opioids,
including death, opioid overdose, hospitalizations, emergency department visits, falls, delirium, nausea, and
constipation.
2) To define the severity, functional consequences, and underlying causes of opioid-related clinically important
medication errors (including preventable/ameliorable ADEs and potential ADEs) among older adults within 30
days of hospital discharge using prospectively collected clinical data from two large healthcare systems in
Massachusetts. Data will be collected through chart review and a 30 day post-discharge telephone interview of
patients discharged on opioids. The detailed clinical data will allow us to classify the adverse event as
preventable/ameliorable, and identify systems improvements that could have prevented/ameliorated the event.
The data sources used for each of these Aims will provide complementary information, allowing for a
comprehensive examination of opioid-related post-discharge ADEs at both the “macroscopic” and
“microscopic” level. A better understanding of the patient- and prescribing-related factors that place patients at
highest risk for opioid-related post-discharge ADEs will inform improvements in healthcare systems to reduce
the incidence and consequences of these potentially devastating events for older adults.
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Risk Factors for Opioid-Related Adverse Drug Events Among Older Adults After Hospitalization for Major Orthopedic Procedures.
老年人因主要骨科手术住院后发生阿片类药物相关不良药物事件的危险因素。
DOI:
10.1097/pts.0000000000001144
发表时间:
2023
期刊:
Journal of patient safety
影响因子:
2.2
作者:
[Herzig,ShoshanaJ, Anderson,TimothyS, Urman,RichardD, Jung,Yoojin, Ngo,LongH, McCarthy,EllenP]
通讯作者:
McCarthy,EllenP
DOI:
10.1371/journal.pmed.1003804
发表时间:
2021-09
期刊:
PLoS medicine
影响因子:
15.8
作者:
[Herzig SJ, Anderson TS, Jung Y, Ngo L, Kim DH, McCarthy EP]
通讯作者:
McCarthy EP
Pain in the United States: Time for a Culture Shift in Expectations, Messaging, and Management.
美国的痛苦:是时候在期望、信息和管理方面进行文化转变了。
DOI:
10.12788/jhm.3277
发表时间:
2019
期刊:
Journal of hospital medicine
影响因子:
2.6
作者:
[Loh,FEllen, Herzig,ShoshanaJ]
通讯作者:
Herzig,ShoshanaJ
Reply to Comment on: Antipsychotics and the Risk of Mortality or Cardiopulmonary Arrest in Hospitalized Adults.
回复评论:抗精神病药物与住院成人死亡或心肺骤停的风险。
DOI:
10.1111/jgs.16546
发表时间:
2020
期刊:
Journal of the American Geriatrics Society
影响因子:
6.3
作者:
[Basciotta,Matthew, Herzig,ShoshanaJ]
通讯作者:
Herzig,ShoshanaJ
Potentially Inappropriate Use of Intravenous Opioids in Hospitalized Patients.
住院患者静脉注射阿片类药物的潜在不当使用。
DOI:
10.12788/jhm.3225
发表时间:
2019
期刊:
Journal of hospital medicine
影响因子:
2.6
作者:
[Moore,AmberB, Navarrett,Scott, Herzig,ShoshanaJ]
通讯作者:
Herzig,ShoshanaJ
共 7 条
Characterizing Opioid-related Adverse Events in Older Adults After Hospital Discharge
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批准号:10199045
-
项目类别:
-
资助金额:$40.0万
-
财政年份:2018
-
负责人:Shoshana J Herzig
-
依托单位:
Improving Use of Sedating Medications in Hospitalized Older Adults
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批准号:9107785
-
项目类别:
-
资助金额:$15.66万
-
财政年份:2013
-
负责人:Shoshana J Herzig
-
依托单位:
Improving Use of Sedating Medications in Hospitalized Older Adults
-
批准号:8867975
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项目类别:
-
资助金额:$15.66万
-
财政年份:2013
-
负责人:Shoshana J Herzig
-
依托单位:
Improving Use of Sedating Medications in Hospitalized Older Adults
-
批准号:8509169
-
项目类别:
-
资助金额:$15.63万
-
财政年份:2013
-
负责人:Shoshana J Herzig
-
依托单位:
Improving Use of Sedating Medications in Hospitalized Older Adults
-
批准号:9291401
-
项目类别:
-
资助金额:$15.68万
-
财政年份:2013
-
负责人:Shoshana J Herzig
-
依托单位:
海外基金