Prescription Opioid Use among Acute Gout Patients Discharged from the Emergency Department

Acute gout is among the most painful inflammatory arthritis and a frequent cause of emergency department (ED) visits. Prescription opioid is the leading contributor to the ongoing opioid epidemic; ED is often the source of the index prescription. Our aim was to assess the burden of opioid use and factors associated with its use among gout patients discharged from the ED. In the electronic health records system of Lifespan (currently contain 2.2 million records), adult gout patients discharged from the ED or hospital were identified using ICD-9 or ICD-10 diagnostic codes. The study period was 03/2015 to 09/2017 and only patients with a primary diagnosis of gout were included. If a patient was seen multiple times, only the first encounter was included. We estimated the frequency, dose and duration of opioids prescribed in these patients. Using multivariable logistic regression, we ascertained the factors associated with increased odds of opioid prescription at discharge among patients with acute gout. Out of the 456 patients, 129 (28.3%) received opioid at discharge; approximately 80% were new. The average dose of prescription was 37.9±17.2mg of morphine equivalent for a median duration of 8 days [5,14]. We noted that patients with polyarticular gout attack, diabetes and those using opioids prior to admission had higher odds of receiving opioids at discharge. Despite the availability of effective treatments, opioids are commonly used for the management of acute gout. The study highlights an opportunity to curb the opioid epidemic among gout patients This article is protected by copyright. All rights reserved.