The following is a summary of “A comparison of opioid dose between home palliative care and hospital palliative care,” published in the January 2024 issue of Primary Care by Iwata, et al.

For a study, researchers sought to compare opioid usage between patients receiving palliative care in-home care and hospital settings.

A cross-sectional study retrospectively recruited patients receiving palliative care in-home care and hospital settings between November 2018 and October 2020. Opioid prescriptions were standardized to oral morphine equivalent (OME) doses at 7 and 14 days before death and analyzed. Additional analysis included multivariable linear regression on the outcome of OME at 7 days, adjusting for medical settings and confounders in patients with opioid prescriptions.

After excluding 21 patients, 209 individuals (48 from home care and 161 from hospital care) were eligible for analysis. The home care group had a higher mean age (74.8 years) and Palliative Prognosis Score (50) compared to the hospital group (70.1 years and 40, respectively). Mean OME at 7 and 14 days before death was numerically higher in the home care group (72.8 mg/day and 53.0 mg/day, respectively) than in the hospital care group (57.7 mg/day and 35.7 mg/day). Statistical tests produced p-values of 0.49 and 0.32 using the Student’s t-test and 0.24 and 0.11 using the Wilcoxon rank sum test at 7 and 14 days, respectively. Multivariable regression analysis of the home care group found a mean OME of 40.7 mg/day with a 95% confidence interval [-0.62, 82.0 (mg/day)], P = 0.06. Additional analysis found a P-value of 0.06 for the medical setting.

While no statistically significant difference in opioid use between home care and hospital care was found, the numerically higher rate of use in the home care group suggests the need for further research.

Reference: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02265-z