The Cost of Opioid-Related Adverse Drug Events

Abstract

Opioids are the cornerstone of pain management; however, their use is associated with a variety of adverse drug events (ADEs) ranging from nausea and vomiting to urinary retention and respiratory depression. The purpose of this review is to describe the frequency and cost associated with different types of opioid-related ADEs to better understand their economic impact. A search of studies published in journals from 1946 to December, 2013, was conducted using MEDLINE and EMBASE. A total of 20 articles were reviewed. Data reflect a substantial economic burden of opioid-related ADEs resulting in high hospital costs, prolonged hospital stays, and substantial health care resource usage. Nausea, vomiting, and constipation are frequent and increased costs occur in all types of pain (surgical, nonsurgical, cancer, noncancer) in both inpatients and outpatients. Given the large economic burden of opioid-related ADEs, prevention rather than treatment may be the most effective strategy.

The effects of acupuncture point Pericardium 6 on hydromorphone-induced nausea and vomiting in healthy dogs

“…In human medical practice, regardless of inpatient or outpatient settings, perioperative nausea and vomiting have been reported to increase the cost of the patient's care by 10–215% (Kane‐Gill et al. ). It is thought that prevention rather than treatment is the most desirable method of minimizing patient costs associated with nausea and vomiting induced by opioids (Kane‐Gill et al.…”

“…It is thought that prevention rather than treatment is the most desirable method of minimizing patient costs associated with nausea and vomiting induced by opioids (Kane‐Gill et al. ). The aim of this study was to provide the attending practitioner with an alternative to traditional pharmaceutical therapy for opioid‐induced nausea and vomiting with minimal cost and side effects.…”

Goals and Objectives to Optimize the Value of an Acute Pain Service in Perioperative Pain Management

“…Regarding constipation, there is 30-70% reported incidence [45]. These unfavorable gastrointestinal events can contribute to treatment cessation [46].…”

Sedation scales: Do they capture the concept of opioid‐induced sedation?

“…This assessment is used along with their critical thinking skills when deciding the safest therapy for pain management. Despite using validated scales, between 0.003 and–4.2% hospitalized patients will experience an opioid‐related adverse event (defined by naloxone exposure or an opioid‐related adverse drug event diagnosis code), including excessive sedation and respiratory depression . In the past 15 years, OIASRD has received increased attention from professional organizations, such as The Joint Commission, the Institute for Healthcare Improvement, and the Centers for Medicare and Medicaid Services; being identified as an important factor in the development of nursing knowledge specific to clinical decision making around pain…”