SHM Converge Scientific Abstract ePoster Gallery-Approved Opioid-Induced Constipation Medication Use in Emergency Department Patients With Opioid-Induced Constipation

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This retrospective study examined adult emergency department (ED) encounters for opioid-induced constipation (OIC) to compare patients who received approved OIC medications in the ED (OIC-Rx), mainly methylnaltrexone (MNTX), versus those who did not.<br /><br />Using hospital database data from April 2016 onward, the researchers identified 32,609 OIC-related ED encounters. The final analytic sample included 21,474 OIC-Rx encounters and 11,135 no-OIC-Rx encounters; a cancer subgroup included 1,053 OIC-Rx and 2,219 no-OIC-Rx encounters. Because treatment choice may differ across patients, the groups were reweighted with entropy balancing to reduce selection bias before comparing outcomes.<br /><br />Results showed that receiving OIC-Rx in the ED was associated with better healthcare resource utilization outcomes. Patients treated with OIC-Rx were more likely to be discharged home, less likely to be hospitalized, and had fewer inpatient days. Effects were especially driven by MNTX, which accounted for over 90% of OIC-Rx use.<br /><br />Economic results were also favorable. Compared with no OIC-Rx, ED treatment with OIC-Rx reduced total healthcare costs by $1,152 per encounter in the overall sample and $922 in the cancer subgroup. Among MNTX-only patients, savings were $1,173 overall and $1,010 in the cancer subgroup. OIC-Rx also reduced inpatient days by about 0.7 per encounter overall and 1.0 in the cancer subgroup.<br /><br />Simulation modeling suggested that, at an average hospital, increasing OIC-Rx use among eligible ED patients could yield meaningful annual cost savings and prevent inpatient days.<br /><br />Overall, the study concluded that approved OIC medications used in the ED are associated with lower costs and reduced hospital utilization, particularly methylnaltrexone.

Asset Subtitle

W. Frank Peacock

Meta Tag

Author List Annie Guérin, George J. Joseph, Jessica Maitland MScPH, Neal E. Slatkin, Patrick Gagnon-Sanschagrin, W. Frank Peacock

Category Research

Concept Emergency Department

Concept Opioid-Induced Constipation

Concept Approved Opioid-Induced Constipation Medication

Concept Study Design

Concept Population Selection

Distinguished Non-Finalist

Presenter Organization Baylor College of Medicine

Presenting Author W. Frank Peacock

Track Value in Hospital Medicine

Keywords

opioid-induced constipation

emergency department

methylnaltrexone

healthcare utilization

hospitalization

cost savings

retrospective study

entropy balancing

inpatient days

cancer subgroup

Emergency Department

Opioid-Induced Constipation

Approved Opioid-Induced Constipation Medication

Study Design

Population Selection