More than 1 in 10 COVID-19 patients got discharge prescription of opioid, benzo, or antipsychotic
COVID-19 patients who were newly prescribed an opioid, benzodiazepine, or antipsychotic upon hospital discharge had a significantly higher risk of rehospitalization or death within 28 days, a single-center study found.
New prescriptions of opioids, benzodiazepines, and antipsychotics following hospitalizations for COVID-19 were common and associated with an increased risk of rehospitalization or death within 28 days of discharge, a recent study found.
Researchers assessed outcomes of 1,319 COVID-19 patients admitted to a tertiary-level medical center in Boston. Of the patients included, 149 (11.3%) were discharged with a new prescription for an opioid, benzodiazepine, or antipsychotic either alone or in combination. Opioids were the most commonly prescribed medication (110 of 149), followed by benzodiazepines (41 of 149) and antipsychotics (22 of 149). Median patient age was 62.9 years, about half of patients included were male, half were White, and about one-third required an ICU stay. Findings of the retrospective cohort study were published by the Journal of Hospital Medicine on May 14.
After adjustment, these new prescriptions were significantly associated with risk of readmission or death within 28 days of discharge (adjusted odds ratio [aOR], 2.44 [95% CI, 1.42 to 4.12]; P=0.001). Age (OR, 1.03; 95% CI, 1.01 to 1.04) and history of substance use disorder (aOR, 2.11; 95% CI, 1.18 to 3.64) were also associated with readmission or death within 28 days of discharge. Patients discharged with a new prescription for one of the three drugs tended to be younger and more likely to have been admitted to the ICU than those not prescribed the drugs.
Oxycodone and lorazepam were the most commonly prescribed opioids and benzodiazepines, respectively, and olanzapine was the most prescribed antipsychotic drug. A limitation to the study is that institution-specific prescription practices may have influenced results, limiting generalizability, the study authors noted. They were also unable to assess persistent use of the drugs among patients after discharge.
Going forward, "modification of prescription patterns by further strengthening reconciliation processes focused on these classes of medications may reduce avoidable harm and improve patient safety," the authors concluded.
