title: New Initiation of Long-Acting Opioids in Long-Stay Nursing Home Residents.
abstract: To estimate the prevalence of new initiation of long-acting opioids since introduction of national efforts to increase prescriber and public awareness on safe use of transdermal fentanyl patches.
  
  
  
  Cross-sectional.
  
  
  
  U.S. nursing homes (NHs).
  
  
  
  Medicare-enrolled long-stay NH residents (N = 22,253).
  
  
  
  Minimum Data Set 3.0 was linked with Medicare enrollment, hospital claims, and prescription drug transaction data (January-December 2011) and used to determine the prevalence of new initiation of a long-acting opioid prescribed to residents in NHs.
  
  
  
  Of NH residents prescribed a long-acting opioid within 30 days of NH admission (n = 12,278), 9.4% (95% confidence interval = 8.9-9.9%) lacked a prescription drug claim for a short-acting opioid in the previous 60 days. The most common initial prescriptions of long-acting opioids were fentanyl patch (51.9% of opioid-naïve NH residents), morphine sulfate (28.1%), and oxycodone (17.2%).
  
  
  
  New initiation of long-acting opioids-especially fentanyl patches, which have been the subject of safety communications-persists in NHs.
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Camilla B
authors.initials: CB
authors.lastname: Pimentel
authors.affiliation: Meyers Primary Care Institute, Worcester, Massachusetts.
authors.forename: Jerry H
authors.initials: JH
authors.lastname: Gurwitz
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Tjia
authors.affiliation: Department of Family Medicine, Alpert Medical School, Brown University, Memorial Hospital of Rhode Island, Providence, Rhode Island.|Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston, Rhode Island.
authors.forename: Anne L
authors.initials: AL
authors.lastname: Hume
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts. kate.lapane@umassmed.edu.
authors.forename: Kate L
authors.initials: KL
authors.lastname: Lapane
mesh_terms: D000279:Administration, Cutaneous; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D002047:Buprenorphine / Q000008:administration & dosage / Q000009:adverse effects; D059350:Chronic Pain / Q000188:drug therapy*; D003692:Delayed-Action Preparations; D004305:Dose-Response Relationship, Drug; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage* / Q000009:adverse effects*; D006707:Homes for the Aged; D006801:Humans; D008134:Long-Term Care; D008297:Male; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D009735:Nursing Homes; D010098:Oxycodone / Q000008:administration & dosage* / Q000009:adverse effects; D010111:Oxymorphone / Q000008:administration & dosage / Q000009:adverse effects; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends; D012237:Rhode Island; D014147:Tramadol / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D000701:Analgesics, Opioid; D003692:Delayed-Action Preparations; D014147:Tramadol; D002047:Buprenorphine; D009020:Morphine; D010111:Oxymorphone; D010098:Oxycodone; D005283:Fentanyl
keywords: analgesics; long-acting opioid; nursing home