Are hospitals overprescribing opiates for pain management for acute and chronic gout attacks during hospital treatment? Physicians in hospitals prescribe opiates to manage acute gout attacks approximately 30% of the time, even though there are other effective therapies available, according to a cohort study. It was reported by doctors from Brown University Warren Alpert School of Medicine and their colleagues that out of 456 patients discharged from the hospital or emergency department who were suffering with gout, 28.3% were prescribed opiates.

Opioids are Not the Only Solution

Research also showed that 25% of gout patients in this setting were given a prescription for opiate for 14 day or longer. The average prescription for opiates for these patients was eight days. Gout is inflammatory by nature, recommended therapies are anti-inflammatories, such as corticosteroids, NSAIDS, and colchicine. These therapies are reported to be very effective to relieve gout attacks.

Pain Management for Acute and Chronic Gout Attacks

It was reported that the most commonly used opiate was oxycodone or an oxycodone combination, which was used by 81%.  The average dose that was taken daily was 37.9 mg of morphine equivalents. Patients who received opiate prescriptions were mostly younger men. Most patients suffered from diabetes, hypertension, and substance abuse history.

Better Coordination of Care is Needed!

Research showed no difference between those using opiates to treat gout and those using other therapies. There was also no difference in systemic factors. It was also noted that opiate prescribing in Europe for initial gout treatment is codeine or tramadol. It seems that it is the overall clinical practice in the United States to prescribe oxycodone rather than less potent opioids. It was concluded that hospital doctors and outpatient doctors could reduce unnecessary prescriptions of opiates with better coordination of care, with regulatory changes and prompts in the electronic record.Pain management for acute and chronic gout attacks should involve the patient’s complaint, history, and ongoing treatment, while working with their doctors to reach the healthiest overall treatment for their gout attacks.

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