Nonfatal Opioid Overdose: Follow-Up Care
In health reform more broadly, quality improvements are focused on preventing unnecessary emergency room use. Most quality improvement projects have emphasized preventing re-hospitalization, with the rationale that health care professionals might not be able to prevent a hospital visit, but with diligent and timely follow-up care, a re-hospitalization for the same issue can be avoided. The same thinking can be applied to nonfatal overdoses.
A transition of care is any movement between two systems, for example, from detox to inpatient treatment, or from the hospital back to a primary care clinic. A recent study in the Annals of Internal Medicine reveals four alarming statistics about the lack of transition of care for patients with chemical health needs, especially when it comes to after-care following a nonfatal overdose:
- Even after a nonfatal opioid overdose, 90% of patients continue to receive prescription opioids
- Of the patients who received an opioid prescription following a nonfatal overdose, 70% of the time the opioid prescription came from the same prescriber who prescribed opioids before the overdose
- Of the patients who received an opioid prescription following a nonfatal overdose, 46% of them had a previous diagnosis of substance use disorder
- Of the patients included in the study sample, 7% of the patients suffered an additional nonfatal opioid overdose during the study period of a year
Some hospital systems and clinics are connected via an integrated electronic medical record (EMR) or health information exchange (HIE); however, Minnesota does not yet have a state-wide health information exchange (HIE). There is a wealth of evidence-based guidelines for effective discharge planning. However, until there are integrated health records in place, and funding to support staffing for transitions of care, Minnesotans, including patients with a recent nonfatal overdose, will continue to fall through the cracks following a hospital discharge.
Annals of Internal Medicine, January 5th 2016, Opioid Prescribing After Nonfatal Overdose and Association with Repeated Overdose: A Cohort Study
Please visit the Opioid Dashboard for more information on opioid overdose death, nonfatal overdose, use, misuse, substance use disorder, prescribing practices, supply, diversion, harm reduction, co-occurring conditions, and social determinants of health.