SHM Converge Scientific Abstract ePoster Gallery-Assessing for Differences in Opioid Administration During Inpatient End-of-Life Care for Patients With Limited English Proficiency

Assessing for Differences in Opioid Administration During Inpatient End-of-Life Care for Patients With Limited English Proficiency

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This retrospective EHR-based study examined whether limited English proficiency (LEP) affected opioid administration for hospitalized patients receiving end-of-life care on a general medicine service at a single academic hospital from 2013 to 2021. Patients were identified as end-of-life if they had an active “Comfort Measures” order set on discharge.<br /><br />The cohort included 2,652 patients, of whom 701 had LEP and 1,951 were English proficient (EP). The study compared opioid exposure using oral morphine equivalents (OME), both as average daily dose and dose received in the last 24 hours before discharge.<br /><br />In unadjusted analyses, LEP patients appeared to receive less opioid medication than EP patients. However, after adjusting for demographic, clinical, and hospitalization factors such as age, race/ethnicity, prior opioid use, cancer pain diagnosis, comorbidity burden, ICU stay, palliative care consult, and year of admission, LEP status was no longer associated with opioid administration.<br /><br />Among the subset of patients discharged deceased (n=1,813), adjusted results also showed no significant difference in either average daily OME or last-24-hour OME between LEP and EP patients.<br /><br />Overall, the study found that once patient and hospitalization characteristics were accounted for, there was no significant disparity in opioid administration at end-of-life based on English proficiency. The authors conclude that LEP status alone did not predict opioid treatment differences in this inpatient end-of-life setting.

Asset Subtitle

Nicole Curatola

Meta Tag

Author List Aksharananda Rambachan, Nicole Curatola, Priya A. Prasad

Category Research

Concept Limited English Proficiency

Concept Opioid Administration

Concept End-of-Life Care

Concept Comfort Measures Order Set

Concept Unadjusted Analysis

Distinguished Finalist

Presenter Organization University of California, San Franscisco

Presenting Author Nicole Curatola

Track Quality Improvement

Keywords

limited English proficiency

LEP

opioid administration

end-of-life care

hospitalized patients

oral morphine equivalents

retrospective study

English proficient

palliative care

general medicine

Limited English Proficiency

Opioid Administration

End-of-Life Care

Comfort Measures Order Set

Unadjusted Analysis