Limits...
Morphine versus Hydromorphone: Does Choice of Opioid Influence Outcomes?

Gulur P, Koury K, Arnstein P, Lee H, McCarthy P, Coley C, Mort E - Pain Res Treat (2015)

Bottom Line: The use of morphine steadily decreased while use of hydromorphone increased in both medical and surgical groups.However, 30-day all cause readmission rates were significantly higher in patients treated with hydromorphone (p < 0.01).There are implications related to resource utilization and these outcomes.

View Article: PubMed Central - PubMed

Affiliation: Massachusetts General Hospital, Boston, MA, USA.

ABSTRACT
Morphine has traditionally been considered the first line agent for analgesia in hospitals; however, in the last few years there has been a shift towards the use of hydromorphone as a first line agent. We conducted a hospital population based observational study to evaluate the increasing use of hydromorphone over morphine in both medical and surgical populations. Additionally, we assessed the effect of this trend on three key outcomes, including adverse events, length of stay, and readmission rates. We evaluated data from the University Health Systems Consortium. Data from 38 hospitals from October 2010 to September 2013 was analyzed for patients treated with either hydromorphone or morphine. The use of morphine steadily decreased while use of hydromorphone increased in both medical and surgical groups. Rescue drugs were used more frequently in patients treated with hydromorphone in comparison to patients treated with morphine (p < 0.01). Patients receiving morphine tended to stay in the hospital for almost one day longer than patients receiving hydromorphone. However, 30-day all cause readmission rates were significantly higher in patients treated with hydromorphone (p < 0.01). Our study highlights that the choice of hydromorphone versus morphine may influence outcomes. There are implications related to resource utilization and these outcomes.

No MeSH data available.


Related in: MedlinePlus

Morphine and hydromorphone use.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4644543&req=5

fig1: Morphine and hydromorphone use.

Mentions: Over the three-year study period, the use of morphine steadily decreased while use of hydromorphone increased in both medical and surgical groups. Specifically, we found that hydromorphone use increased by 22% in surgical patients and by 17% in medical patients. On the other hand, morphine use decreased by 22% in surgical patients and by 6% in medical patients. A noteworthy change occurred over the study period as hydromorphone overtook morphine as the more commonly used analgesic in surgical patients (see Figure 1).


Morphine versus Hydromorphone: Does Choice of Opioid Influence Outcomes?

Gulur P, Koury K, Arnstein P, Lee H, McCarthy P, Coley C, Mort E - Pain Res Treat (2015)

Morphine and hydromorphone use.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4644543&req=5

fig1: Morphine and hydromorphone use.
Mentions: Over the three-year study period, the use of morphine steadily decreased while use of hydromorphone increased in both medical and surgical groups. Specifically, we found that hydromorphone use increased by 22% in surgical patients and by 17% in medical patients. On the other hand, morphine use decreased by 22% in surgical patients and by 6% in medical patients. A noteworthy change occurred over the study period as hydromorphone overtook morphine as the more commonly used analgesic in surgical patients (see Figure 1).

Bottom Line: The use of morphine steadily decreased while use of hydromorphone increased in both medical and surgical groups.However, 30-day all cause readmission rates were significantly higher in patients treated with hydromorphone (p < 0.01).There are implications related to resource utilization and these outcomes.

View Article: PubMed Central - PubMed

Affiliation: Massachusetts General Hospital, Boston, MA, USA.

ABSTRACT
Morphine has traditionally been considered the first line agent for analgesia in hospitals; however, in the last few years there has been a shift towards the use of hydromorphone as a first line agent. We conducted a hospital population based observational study to evaluate the increasing use of hydromorphone over morphine in both medical and surgical populations. Additionally, we assessed the effect of this trend on three key outcomes, including adverse events, length of stay, and readmission rates. We evaluated data from the University Health Systems Consortium. Data from 38 hospitals from October 2010 to September 2013 was analyzed for patients treated with either hydromorphone or morphine. The use of morphine steadily decreased while use of hydromorphone increased in both medical and surgical groups. Rescue drugs were used more frequently in patients treated with hydromorphone in comparison to patients treated with morphine (p < 0.01). Patients receiving morphine tended to stay in the hospital for almost one day longer than patients receiving hydromorphone. However, 30-day all cause readmission rates were significantly higher in patients treated with hydromorphone (p < 0.01). Our study highlights that the choice of hydromorphone versus morphine may influence outcomes. There are implications related to resource utilization and these outcomes.

No MeSH data available.


Related in: MedlinePlus