{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T03:04:41Z","timestamp":1773284681743,"version":"3.50.1"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,2,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Many patients use opioids for nonmalignant pain, and opioid use in the general population has been associated with poor long\u2010term outcomes. The use of high\u2010risk medications, including opioid analgesics, may increase the risk of unplanned healthcare utilization.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We performed a nested evaluation in the VICS (Vanderbilt Inpatient Cohort Study) (N=3000) on patients with an admitting diagnosis of acute coronary syndrome and\/or acute decompensated heart failure. Patient enrollment occurred from October 2011 until December 2015 and involved a single investigational site, Vanderbilt University Medical Center (Nashville, TN). Of the 2495 eligible patients, 501 (20%) were discharged with an opioid prescription and were predominantly white and men, with a median age of 59 (interquartile range, 53\u201367) years. Our primary outcome was unplanned healthcare utilization, which included emergency department presentation or readmission. Secondary outcomes included mortality and a composite of planned utilization behaviors: cardiac rehabilitation and provider follow\u2010up within 30\u00a0days. Cox proportional hazards models did not show a statistically significant association with increased unplanned utilization (adjusted hazard ratio, 1.06; 95% CI, 0.87\u20131.28) or mortality (adjusted hazard ratio, 1.08; 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 0.84\u20131.39), compared with those without opioids at discharge. Patients discharged with opioids were less likely to complete planned healthcare utilization (adjusted odds ratio, 0.69; 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 0.52\u20130.91).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">There are decreased odds of planned healthcare utilization among patients with acute coronary syndrome and acute decompensated heart failure discharged with opioid medication. It is imperative to understand how opioid use can affect a patient's relationship with the healthcare system.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.118.010664","type":"journal-article","created":{"date-parts":[[2019,1,28]],"date-time":"2019-01-28T21:07:58Z","timestamp":1548709678000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Opioid Prescriptions at Hospital Discharge Are Associated With More Postdischarge Healthcare Utilization"],"prefix":"10.1161","volume":"8","author":[{"given":"Justin S.","family":"Liberman","sequence":"first","affiliation":[{"name":"Veterans Health Administration Tennessee Valley VA Health Care System Geriatric Research Education Clinical Center Nashville TN"},{"name":"Deparment of Anesthesiology Vanderbilt University Medical Center Nashville TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren R.","family":"Samuels","sequence":"additional","affiliation":[{"name":"Veterans Health Administration Tennessee Valley VA Health Care System Geriatric Research Education Clinical Center Nashville TN"},{"name":"Department of Biostatistics Vanderbilt University Medical Center Nashville TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Goggins","sequence":"additional","affiliation":[{"name":"Department of Medicine Vanderbilt University Medical Center Nashville TN"},{"name":"Center for Health Services Research Vanderbilt University Medical Center Nashville TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunil","family":"Kripalani","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Vanderbilt University Medical Center Nashville TN"},{"name":"Department of Medicine Vanderbilt University Medical Center Nashville TN"},{"name":"Center for Health Services Research Vanderbilt University Medical Center Nashville 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