New prescribing approach could reduce intravenous opioid exposure

Intravenous opioid doses were reduced by 84% and pain scores improved after researchers trialled a new prescribing standard that favours oral and subcutaneous administration.

Opioid tablets, close up

A new standard of inpatient opioid prescribing preferring oral and subcutaneous administration may be associated with significant reductions in intravenous opioid exposure, results from a US study show[1]

Researchers compared opioid use from the beginning of a six-month control period to three months after adoption of the new standard, which was initiated alongside education for prescribers and nursing staff on awareness of the subcutaneous route.

They found that intravenous opioid doses were reduced by 84% during the intervention period and combined doses of parenteral opioids, given either intravenously or subcutaneously, were reduced by 55%.

The daily rate of patients administered any parenteral opioid decreased by 57% during the intervention period. The researchers also found that pain scores improved significantly in the intervention group on days four and five after intervention.

Lead author, Adam Ackerman, said: “Intravenous opioids commonly given in hospitals for pain control are an especially dangerous source of exposure.

“Our study suggests that ensuring providers and nurses are made aware of less risky methods of giving opioids can lead to less overall exposure for patients while still controlling their pain.”


 [1] Ackerman A, O’Conner P, Doyle D et al. An intervention to reduce intravenous opioid exposure in hospitalized medical patients. JAMA Intern Med 2018;178(6):1–6. doi: 10.1001/jamainternmed.2018.1044

Last updated
Clinical Pharmacist, CP, July 2018, Vol 10, No 7;10(7):DOI:10.1211/PJ.2018.20205055

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