Table 2:
Predictors of Opioid Dose Change Compared to Dose Staying the Same Following Hospitalization
| Patient Characteristics | Dose Discontinued (N=308) Versus stayed the Same (N=279) |
Dose Decreased (N=149) Versus stayed the Same (N=279) |
Dose Increased (N=128) Versus stayed the Same N=279 |
|---|---|---|---|
| OR (95% CI) | OR (95% CI) | OR (95% CI) | |
| Diagnosis at Hospitalization | |||
| Opioid-Related | |||
| Dependence/Abuse | 2.17 (1.19-3.96) | 0.95 (0.49-1.86) | 1.19 (0.67-2.12) |
| Overdose | ref | ref | ref |
| Age, y | |||
| <35 | 1.85 (0.82-4.17) | 1.04 (0.38-2.83) | 0.71 (0.34-1.48) |
| 35-55 | 1.10 (0.63-1.91) | 0.85 (0.45-1.60) | 1.28 (0.75-2.19) |
| 56-75 | ref | ref | ref |
| ≥76 | 1.49 (0.38-5.86) | 2.22 (0.56-8.80) | 0.31 (0.06-1.71) |
| Gender | |||
| Male | ref | ref | ref |
| Female | 0.90 (0.37-2.19) | 0.87 (0.32-2.39) | 0.82 (0.36-1.88) |
| Race | |||
| White | ref | ref | ref |
| Black | 0.98 (0.51-1.89) | 0.71 (0.32-1.57) | 1.04 (0.56-1.92) |
| Other/ Unknown | 1.25 (0.43-3.62) | 1.40 (0.44-4.45) | 1.22 (0.42-3.56) |
| Ethnicity | |||
| Hispanic/Latino | 1.79 (0.41-7.75) | 0.61 (0.09-4.29) | 1.04 (0.30-3.57) |
| Not Hispanic/Latino | ref | ref | ref |
| Daily Opioid Dosage (MME) before hospitalization* (56-63 days before) | |||
| 0 | * | * | 0.23 (0.13-0.39) |
| >0 to <50 | ref | ref | ref |
| 50 to 90 | 0.74 (0.35-1.57) | 3.26 (1.45-7.30) | 0.58 (0.22-1.49) |
| >90 | 0.49 (0.27-0.90) | 2.51 (1.28-4.89) | 0.19 (0.08-0.83) |
| Mental Health Diagnoses | |||
| Depression | 0.94 (0.56-1.58) | 0.86 (0.48-1.53) | 1.02 (0.63-1.65) |
| Serious Mental Illness | 1.39 (0.74-2.60) | 1.82 (0.90-3.69) | 0.90 (0.51-1.59) |
| PTSD | 0.93 (0.56-1.56) | 0.88 (0.49-1.58) | 0.80 (0.48-1.32) |
| Anxiety | 1.38 (0.81-2.34) | 1.14 (0.61-2.11) | 1.42 (0.86-2.34) |
| SUD | 1.83 (1.00-3.33) | 1.04 (0.54-2.00) | 0.73 (0.40-1.31) |
| Pain Diagnoses | |||
| Acute Pain | 1.40 (0.82-2.38) | 1.60 (0.89-2.89) | 1.08 (0.66-1.78) |
| Chronic Pain | 0.75 (0.30-1.87) | 1.67 (0.50-5.57) | 1.21 (0.57-2.54) |
| Headache | 0.83 (0.43-1.62) | 0.94 (0.44-2.00) | 1.42 (0.74-2.73) |
| Neuropathy | 1.63 (0.60-4.43) | 2.58 (0.92-7.24) | 2.17 (0.89-5.30) |
| Cancer | 1.19 (0.60-2.37) | 1.10 (0.52-2.31) | 0.93 (0.45-1.91) |
| Elixhauser Comorbidity Index | 1.01 (0.97-1.06) | 1.02 (0.98-1.07) | 1.04 (1.00-1.08) |
*
comparing dose 57-63 days post-hospitalization to 57-63 days pre-hospitalization
MME= morphine milligram equivalents, SMI=Serious Mental Illness, PTSD= Post-traumatic Stress Disorder, SUD= Substance Use Disorder