Opioid Prescriptions for Older Adults Discharged After Inpatient Orthopedic Rehabilitation: A Retrospective Study

To guide efforts in reducing discharge opioid prescribing, we aimed to investigate the rate of discharge with opioids for opioid-naïve older adults in inpatient orthopedic rehabilitation and to identify factors associated with this outcome.

This is a single-center case-control study of opioid-naïve older adults participating in inpatient orthopedic rehabilitation, with patients grouped based on whether they received an opioid prescription upon discharge. Patient data were collected through the electronic health record. Logistic regression was used to assess for variables that were associated with discharge with an opioid prescription.

Three hundred ninety-one patients were included, with 238 (60.9%) discharged with an opioid prescription. Factors predicting receiving an opioid prescription included longer acute care length of stay, admission for knee replacement, higher pain scores, higher opioid dose, a shorter rehab length of stay, and the absence of a dementia diagnosis. Rates were highest in patients aged 65-74 (77.17%) and lowest in patients aged 85+ (49.59%); however, age was not an independent predictor when all other factors were considered.

A large proportion of older patients were discharged from inpatient orthopedic rehabilitation with an opioid prescription, which may be linked to intrinsic and extrinsic patient factors that influence opioid prescribing.