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Healthcare Facilities Risk Management: Opioid Use in Elderly

Posted on: March 13, 2015 by Caitlin Morgan

The National Safety Council recently released its report, “Psychological and Physical Side Effects of Pain Medications”, citing that the risk of death and unintentional injury is particularly high for elderly adults taking opioid painkillers. According to the report, elderly taking opioids such as Vicodin and Oxycontin have a greater risk of having a cardiovascular event, 68% greater risk for being hospitalized for an adverse drug event, and 87% greater risk of dying. Clearly, these medications should be used with extreme caution and only after extensive consideration and discussion regarding the likelihood of an adverse event.

The report also cites that Medicare claims show that the risk of falls in the elderly taking opioids for pain increased by 64% compared to those taking NSAIDs (nonsteroidal anti-inflammatory drugs). This is particularly important for nursing homes, assisted living facilities and other long-term care facilities to take note of. In fact, the risk of fracture of the humerus (the bone in the upper arm) was nine times greater for those on opioids. The risk of fracture of the hip was 3 times greater for those on opioids. Moreover, the risk of fall and fracture in the elderly was 3 to 4 times greater in those on opioid pain medications for control of the pain of osteoarthritis  compared to those taking NSAIDs. This is important because complications of hip fracture are a leading cause of death in elderly women, and up to half of elderly adults hospitalized for hip fracture never return to their previous level of function.

The National Safety Council concludes that with this and other evidence on the opioid side effect profile that everyone on chronic opioid treatment should undergo periodic evaluation to assess the risk of opioid-related side effects. In addition, for healthcare facilities, including nursing homes and assisted-living facilities, there are measures that should be taken to help stem the risks associated with opioids, including death:

  • Educate nurses to recognize factors associated with a higher likelihood for adverse events from opioid therapies.
  • Implement population- and institution-specific practice policies and procedures and surveillance to ensure adequate monitoring, safe patient environments, and review of opioid-induced adverse events.
  • Use an interprofessional approach to design patient goals and expected outcomes of institutional efforts for achieving patient safety in opioid therapy. Document and communicate risk for respiratory depression so that information is accessible across the continuum of care.

Caitlin Morgan specializes in providing healthcare facilities, including nursing homes and assisted living facilities, with comprehensive insurance programs. Part of this is providing them with risk management strategies to help them stem losses. We would be happy to discuss our programs with you to see how we can help your insureds with a competitive insurance protection plan. Give us a call at 877.226.1027.

Sources: National Safety Council

 

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