Factors associated with new analgesic requirements following critical illness

Andonovic, M., Shaw, M., Quasim, T. , MacTavish, P. and McPeake, J. (2023) Factors associated with new analgesic requirements following critical illness. Journal of Intensive Care Medicine, (doi: 10.1177/08850666231219916) (Early Online Publication)

Abstract

Background: Chronic opioid use represents a significant burden to global healthcare with adverse long-term outcomes. Elevated patient reported pain levels and analgesic prescriptions have been reported following discharge from critical care. We describe analgesic requirements following discharge from hospital and identify if a critical care admission is a significant factor for stronger analgesic prescriptions. Methods: This retrospective observational cohort study identified patients in the UK Biobank with a registered admission to any UK hospital between January 1, 2010 and December 31, 2015 and information on prescriptions drawn both prior to and following hospital discharge. Two matched cohorts were created from the dataset: critical care patients and hospital patients admitted without a critical care encounter. Outcomes were analgesic requirements following hospital discharge and factors associated with increased analgesic prescriptions. Multivariable logistic regression was used to identify factors associated with prescriptions from higher steps on the World Health Organization (WHO) analgesic ladder. Results: In total, 660 formed the total study population. Strong opioid prescriptions following discharge were significantly higher in the critical care cohort (P value <.001). Critical care admission (OR = 1.45) and increasing Townsend deprivation (OR = 1.04) index were significantly associated with increasing strength of analgesic prescriptions following discharge. Conclusions: Critical care patients require stronger analgesic prescriptions in the 12 months following hospital discharge. Patients from areas of high socioeconomic deprivation may also be associated with increased analgesic requirements. Multidisciplinary support is required for patients who may be at risk of chronic opioid use and could be delivered within critical care recovery programs.

• Item Type: Articles
• Status: Early Online Publication
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Mactavish, Mrs Pamela and Quasim, Professor Tara and Andonovic, Dr Mark and McPeake, Dr Jo and Shaw, Dr Martin
• Authors: Andonovic, M., Shaw, M., Quasim, T., MacTavish, P., and McPeake, J.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Nursing and Health Care
• Journal Name: Journal of Intensive Care Medicine
• Publisher: SAGE Publications
• ISSN: 0885-0666
• ISSN (Online): 1525-1489
• Published Online: 12 December 2023
• Copyright Holders: Copyright © The Author(s) 2023
• First Published: First published in Journal of Intensive Care Medicine 2023
• Publisher Policy: Reproduced under a Creative Commons license