"Our study suggests opportunities for identifying patients at-risk for overdosing," said study leader Joseph Boscarino, Ph.D., MPH, Geisinger addiction researcher and senior epidemiologist. "We've found that patients who are taking a higher doses of prescription opioids combined with psychotropic medicines may need closer monitoring to avoid death and other serious complications."
Being married and having private health insurance were found to have a protective effect, while history of previous addiction, mental illness and having other chronic diseases were all found to be conditions associated with adverse overdose outcomes, including death.
Geisinger investigators analyzed the electronic health records (EHRs) of more than 2,000 patients admitted to the hospital for overdoses between April 2005 and March 2015. Among them, 9.4 percent died within a year.
Patients had an average age of 52, were more often female (54 percent), not married (64 percent) and unemployed (78 percent). Their concurrent chronic diseases also included cardiovascular disease (22 percent), diabetes (14 percent), cancer (13 percent) and the presence of one or more mental health disorders (35 percent).
Predictors of the worst patient outcomes – including death, repeated overdoses, frequent health care service use and higher related costs – were found to be higher prescription opioid use, having concurrent chronic diseases, having concurrent mental disorders, and concurrent use of other psychotropic medications.
"These patients have a history of addiction and other serious mental illness both before and after their overdose, as well as current chronic diseases," Dr. Boscarino said.
Geisinger researchers will present results from "A 10-year Retrospective Study of Opioid Overdoses among Patients in a Large Integrated Healthcare System" at the International Conference on Opioids in Boston on Sunday, June 5.
Opioids – including prescription opioid pain relievers and heroin – killed more than 28,000 people in 2014, more than any year on record, according to the Centers for Disease Control and Prevention.
This research was funded and completed in collaboration with Indivior Inc., Richmond, Va., a global specialty pharmaceutical company with a legacy of patient advocacy, health policy, and evidence-based practice models that have advanced addiction treatment.
Geisinger Health System is an integrated health services organization widely recognized for its innovative use of the electronic health record and the development of innovative care delivery models such as ProvenHealth Navigator® and ProvenCare®. As one of the nation's largest health service organizations, Geisinger serves more than 3 million residents throughout 45 counties in central, south-central and northeast Pennsylvania, and also in southern New Jersey with the addition of AtlantiCare, a National Malcolm Baldrige Award recipient. The physician-led system is comprised of approximately 30,000 employees, including nearly 1,600 employed physicians, 12 hospital campuses, two research centers and a 510,000-member health plan, all of which leverage an estimated $8.9 billion positive impact on the Pennsylvania economy. Geisinger has repeatedly garnered national accolades for integration, quality and service. In addition to fulfilling its patient care mission, Geisinger has a long-standing commitment to medical education, research and community service. For more information, visit www.geisinger.org, or follow the latest Geisinger news and more on Twitter and Facebook.
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SOURCE Geisinger Health System