Heart Patients Who Are Given Opioids Less Likely to Seek Follow-Up Care

By Jane Farrell

Heart disease patients who were prescribed opioids at hospital discharge were less likely to follow up with their healthcare provider or to participate in heart rehabilitation than patients who were not prescribed the drugs, new research shows.

The study, published in the Journal of the American Heart Association, comes as the nation’s opioid epidemic continues, with the risks versus benefits of the strong painkillers being questioned. Previous research found health problems among patients prescribed opioids for non-cancer-related pain; another study linked opioid use to an increased risk of atrial fibrillation.

In this latest study, researchers analyzed 2,495 patients, most of them white men with an average age of 60, who were discharged from Vanderbilt University Medical Center for heart attack, sudden heart failure, or both between October 2011 and December 2015. Twenty percent of patients were discharged with an opioid prescription.

Compared to those who weren’t prescribed opioids at discharge, researchers found patients who were prescribed opioids were:

less likely to follow up with their healthcare provider or participate in heart rehabilitation thirty days after discharge; and

slightly more likely to visit the emergency room, be readmitted to the hospital, or to die within 90 days.

“Hospital discharge provides a unique opportunity to evaluate each patient’s medication regimen,” said study lead author Justin S. Liberman, M.D., M.P.H., assistant professor of anesthesiology at Vanderbilt University Medical Center in Nashville, Tennessee. “It’s important for healthcare providers to understand the other ways that opioids may affect a patient’s future interactions with the healthcare system.”

Researchers reviewed patients’ medical records through the Vanderbilt Inpatient Cohort Study. After hospital discharge, participants provided information by telephone about their use of medical services. Interviews occurred 2-3 days, 30 days and 90 days after discharge.

It’s possible that diminished physical and mental function may have contributed to the lack of follow-up.

The study shows an association but does not prove that opioid prescriptions caused patients to miss follow-up care. Researchers said that it’s possible that diminished physical and mental function, known effects of opioids, contributed to the lack of follow-up.

The study may be limited by a lack of information about the number of opioids taken and their duration of use. Also, the study focused on one hospital with a primarily white population and may not apply to others.