{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T20:28:06Z","timestamp":1789417686583,"version":"build-2803163510"},"reference-count":43,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T00:00:00Z","timestamp":1671062400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Long-term opioid use is an increasingly important problem related to the ongoing opioid epidemic. The purpose of this study was to identify patient, hospitalization and system-level determinants of long term opioid therapy (LTOT) among patients recently discharged from hospital.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Design<\/jats:title>\n<jats:p>To be eligible for this study, patient needed to have filled at least one opioid prescription three-months post-discharge. We retrieved data from the provincial health insurance agency to measure medical service and prescription drug use in the year prior to and after hospitalization. A multivariable Cox Proportional Hazards model was utilized to determine factors associated with time to the first LTOT occurrence, defined as time-varying cumulative opioid duration of \u2265 60 days.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Overall, 22.4% of the 1,551 study patients were classified as LTOT, who had a mean age of 66.3 years (SD = 14.3). Having no drug copay status (adjusted hazard ratio (aHR) 1.91, 95% CI: 1.40\u20132.60), being a LTOT user before the index hospitalization (aHR 6.05, 95% CI: 4.22\u20138.68) or having history of benzodiazepine use (aHR 1.43, 95% CI: 1.12\u20131.83) were all associated with an increased likelihood of LTOT. Cardiothoracic surgical patients had a 40% lower LTOT risk (aHR 0.55, 95% CI: 0.31\u20130.96) as compared to medical patients. Initial opioid dispensation of &gt; 90 milligram morphine equivalents (MME) was also associated with higher likelihood of LTOT (aHR 2.08, 95% CI: 1.17\u20133.69).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions and relevance<\/jats:title>\n<jats:p>Several patient-level characteristics associated with an increased risk of \u2265 60 days of cumulative opioid use. The results could be used to help identify patients who are at high-risk of continuing opioids beyond guideline recommendations and inform policies to curb excessive opioid prescribing.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0278992","type":"journal-article","created":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T18:50:59Z","timestamp":1671130259000},"page":"e0278992","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Determinants of long-term opioid use in hospitalized patients"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1785-223X","authenticated-orcid":true,"given":"Siyana","family":"Kurteva","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Abrahamowicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniala","family":"Weir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara","family":"Gomes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn","family":"Tamblyn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,12,15]]},"reference":[{"issue":"no. 12","key":"pone.0278992.ref001","doi-asserted-by":"crossref","first-page":"2541","DOI":"10.2105\/AJPH.2009.180646","article-title":"Age and gender trends in long-term opioid analgesic use for noncancer pain","volume":"vol. 100","author":"C. 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Kurteva S, Beauchamp ME, Tamblyn R, \"Flexible modeling of opioid exposure provides new insights in its association with adverse outcomes.,\" [Prepared for journal submission]."},{"key":"pone.0278992.ref007","article-title":"Risk of Prolonged Opioid Use Among Opioid-Naive Patients Following Common Hand Surgery Procedures","author":"S. P. Johnson","year":"2016","journal-title":"The Journal of hand surgery"},{"issue":"no. 4","key":"pone.0278992.ref008","doi-asserted-by":"crossref","first-page":"243","DOI":"10.12788\/jhm.2930","article-title":"Predictors of Long-Term Opioid Use After Opioid Initiation at Discharge From Medical and Surgical Hospitalizations","volume":"vol. 13","author":"H. J. Mosher","year":"2018","journal-title":"Journal of hospital medicine"},{"issue":"no. 1","key":"pone.0278992.ref009","first-page":"12","article-title":"Predictors of Transitioning to Incident Chronic Opioid Therapy Among Working-Age Adults in the United States","volume":"vol. 11","author":"J. D. 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Pugely","year":"2018","journal-title":"The spine journal: official journal of the North American Spine Society"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0278992","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T18:51:26Z","timestamp":1671130286000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0278992"}},"subtitle":[],"editor":[{"given":"Vijayaprakash","family":"Suppiah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,12,15]]},"references-count":43,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12,15]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0278992","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,15]]}}}