Opioid Provision After Inpatient Care is Associated With Poor Outcomes in Inflammatory Bowel Disease

In this study, we investigate clinical outcomes of inflammatory bowel disease (IBD) patients prescribed opioids after discharge from the hospital or emergency department (ED).

IBD is commonly associated with abdominal pain. Opioids are frequently prescribed to address pain in IBD patients. Importantly, however, there is limited evidence of analgesic benefit. In addition, there are significant safety concerns about opioid use in this setting.

This retrospective study utilized Merative MarketScan claims databases to identify IBD patients who had a hospital or ED visit between 2017 and 2021. Two patient groups were formed based on whether they received an opioid prescription within 7 days of discharge or not. Demographics and baseline clinical features were evaluated. Using χ2 tests and logistic regression, clinical outcomes were compared between groups at 3 time points (1, 3, and 6 mo) starting 7 days after discharge.

Thirty-five thousand eight hundred ninety IBD patients were included in the analysis, with 7892 (22.0%) patients in the opioid prescription group. Using logistic regression analysis, IBD opioid users were found to be significantly more likely to experience repeat ED visits, hospitalizations and opioid prescriptions at multiple time points. IBD opioid users were also more likely to receive corticosteroids and undergo medication escalation during follow-up. Ulcerative colitis opioid users also trended toward being more likely to undergo IBD-associated surgery 6 months after discharge.

Patients who are prescribed opioids after acute hospital care are more likely to have poor clinical outcomes. Physicians should avoid prescribing opioids to IBD patients at discharge from the ED or hospital.