Opioid analgesic stewardship: 9b - Proportion of admitted patients separated from hospital with a supply or prescription of opioid analgesics where the supply or prescription exceeded 7 days of treatment
Indicator Attributes
Identifying and definitional attributes | |
Metadata item type: | Indicator |
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Indicator type: | Indicator |
Short name: | 9b - Proportion of admitted patients separated from hospital with a supply or prescription of opioid analgesics where the supply or prescription exceeded 7 days of treatment |
METEOR identifier: | 755574 |
Registration status: | Australian Commission on Safety and Quality in Health Care, Standard 27/04/2022 |
Description: | The proportion of admitted patients separated from hospital with a supply or prescription of opioid analgesics where the supply or prescription exceeded 7 days of treatment. |
Rationale: | Appropriate opioid analgesic prescribing on discharge balances adequate pain relief with reducing the risk of prolonged opioid analgesic use and reducing community reservoirs of unused opioid analgesics. If a hospital inpatient is discharged with an opioid analgesic, the quantity may be for up to a maximum of 7 days’ treatment to reduce and stop the medicine. The quantity should be based on the expected course of the patient’s condition, the trajectory of opioid analgesic dose for the inpatient, the patient’s previous 24 hour in-patient opioid analgesic usage, and the day of the week the patient is discharged. |
Indicator set: |
Collection and usage attributes | |
Computation description: | The numerator and denominator include patients admitted to hospital. The numerator and denominator only include patients that separate from the hospital to their usual place of residence, which may include a residential care facility. The Separation mode data element for admitted patients can be used to help identify denominator cases. Inclusion values for this data element are: 21 - Discharge/transfer to a residential aged care service, which is not the usual place of residence 22 - Discharge/transfer to a residential aged care service, which is the usual place of residence 90 - Other: includes discharge to usual residence (not including residential aged care), own accommodation/welfare institution (includes prisons, hostels and group homes providing primarily welfare services). Presented as a percentage. |
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Computation: | (Numerator ÷ Denominator) x 100 |
Numerator: | Number of patients in the denominator who received a supply or prescription of opioid analgesics that exceeded 7 days of treatment. |
Denominator: | Number of admitted patient episodes where the patient separated from hospital with a supply or prescription of opioid analgesics. |
Comments: | This indicator is based on existing indicators in use in the United States. For example, the following indicator in the Houston Methodist Hospital Study (Rizk et al, 2019) ‘Proportion of opioid discharge prescriptions that exceed 7 days of treatment’. |
Representational attributes | |
Representation class: | Percentage |
Data type: | Real |
Unit of measure: | Service event |
Format: | N[NN] |
Source and reference attributes | |
Submitting organisation: | Australian Commission on Safety and Quality in Health Care |
Reference documents: | Australian Commission on Safety and Quality in Health Care. Opioid Analgesic Stewardship in Acute Pain Clinical Care Standard – Acute care edition. Sydney: ACSQHC; 2022. Rizk E, Swan JT, Cheon O, Colavecchia AC, Bui LN, Kash BA, Chokshi SP, Chen H, Johnson ML, Liebl MG, Fink E. Quality indicators to measure the effect of opioid stewardship interventions in hospital and emergency department settings. American Journal of Health-System Pharmacy. 2019 Feb 15;76(4):225-35. https://doi.org/10.1093/ajhp/zxy042 |