Most Emergency Department Patients Prescribed Opioids Are Not Prescribed Laxatives

Ali S. Raja, MD, MBA, MPH, FACEP reviewing Hunold KM et al. Acad Emerg Med 2015 Aug 20.

Less than 1% of ED patients given prescriptions for opioids received prescriptions for laxatives, compared with 42% of patients who presented for constipation.

Many patients presenting to U.S. emergency departments (EDs) are prescribed opiates at discharge. While opiates are effective for analgesia, one of their most common side effects is constipation, which can affect up to 20% of patients older than 65. Researchers analyzed National Hospital Ambulatory Medical Care Survey data from 2010 to determine how frequently adult patients prescribed opioids were also prescribed laxatives. To verify that laxative prescriptions were captured by the database, ED visits for patients presenting for constipation were also analyzed.

There were 5291 ED visits among adults without constipation who were discharged with opioids, representing an estimated 21 million such visits nationwide (including 1.9 million for patients aged 65 years and older). Among all adult patients prescribed opioids, 0.9% received laxative prescriptions (1.0% among those aged 65 and older). In contrast, laxatives were prescribed for 42% of adult patients who presented with constipation.

Citation(s):

Hunold KM et al. Constipation prophylaxis is rare for adults prescribed outpatient opioid therapy from U.S. emergency departments. Acad Emerg Med 2015 Aug 20; [e-pub].