# Characterizing Opioid-related Adverse Events in Older Adults After Hospital Discharge

> **NIH AHRQ R01** · BETH ISRAEL DEACONESS MEDICAL CENTER · 2020 · $390,111

## Abstract

PROJECT SUMMARY/ABSTRACT
For the more than 12 million adults age 65 and older hospitalized each year in the United States (U.S.), the
transition out of the hospital is an exceptionally vulnerable time in the care continuum. Post-discharge adverse
events are common, and medications are the leading cause of such adverse events, which disproportionately
affect older adults owing to greater degrees of comorbidity and polypharmacy, as well as altered
pharmacokinetics and pharmacodynamics of drugs. Opioids in particular are consistently among the top
medication classes to cause post-discharge adverse drug events (ADEs), and are prescribed to millions of
older adults after hospital discharge each year. However, the specific nature of post-discharge opioid-related
ADEs and patient- and prescribing-related predictors of such events have not been characterized. The broad
goal of the proposed work is to address this knowledge gap by defining the incidence, characteristics, and
predictors of post-discharge opioid-related ADEs in older adults. Such knowledge is crucial as a prelude to
developing successful, targeted interventions to reduce the adverse consequences of opioid use, particularly
for older adults during this highly vulnerable window of care. The Specific Aims of this proposal are:
1) To define the incidence and predictors of adverse events within 30 days of hospital discharge among older
adults with an opioid claim in the week after discharge using a large national dataset. Using claims data from
Medicare (the largest insurer for U.S. adults age 65+), we will determine the incidence and patient- and
prescribing-related risk factors for post-discharge adverse events among older adults discharged on opioids,
including death, opioid overdose, hospitalizations, emergency department visits, falls, delirium, nausea, and
constipation.
2) To define the severity, functional consequences, and underlying causes of opioid-related clinically important
medication errors (including preventable/ameliorable ADEs and potential ADEs) among older adults within 30
days of hospital discharge using prospectively collected clinical data from two large healthcare systems in
Massachusetts. Data will be collected through chart review and a 30 day post-discharge telephone interview of
patients discharged on opioids. The detailed clinical data will allow us to classify the adverse event as
preventable/ameliorable, and identify systems improvements that could have prevented/ameliorated the event.
The data sources used for each of these Aims will provide complementary information, allowing for a
comprehensive examination of opioid-related post-discharge ADEs at both the “macroscopic” and
“microscopic” level. A better understanding of the patient- and prescribing-related factors that place patients at
highest risk for opioid-related post-discharge ADEs will inform improvements in healthcare systems to reduce
the incidence and consequences of these potentially devastating events ...

## Key facts

- **NIH application ID:** 9928901
- **Project number:** 5R01HS026215-03
- **Recipient organization:** BETH ISRAEL DEACONESS MEDICAL CENTER
- **Principal Investigator:** Shoshana J Herzig
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2020
- **Award amount:** $390,111
- **Award type:** 5
- **Project period:** 2018-09-01 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9928901

## Citation

> US National Institutes of Health, RePORTER application 9928901, Characterizing Opioid-related Adverse Events in Older Adults After Hospital Discharge (5R01HS026215-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9928901. Licensed CC0.

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