Geisinger EHR analytics project helps predict opioid overdoses
Researchers at Geisinger Health System examined electronic health record data of more than 2,000 patients admitted to the hospital for overdoses between April 2005 and March 2015. The data – factoring in mental health, marital status, employment status – helps the health system predict which patients are at most risk of fatal overdoses and other complications.
Patients who were married and had private health insurance were less likely to experience such adverse effects, the research shows. But a history of addiction, mental illness and other chronic diseases were all found to be associated with fatal overdoses.
"Our study suggests opportunities for identifying patients at-risk for overdosing," said Geisinger addiction researcher and senior epidemiologist Joseph Boscarino, the study's lead investigator, in a statement. "We've found that patients who are taking a higher dose of prescription opioids combined with psychotropic medicines may need closer monitoring to avoid death and other serious complications.”
Combined, prescription opioids and heroin killed more than 28,000 people in 2014, according to the Centers for Disease Control and Prevention – more than any year on record. Of the patients admitted to Geisinger in the 10-year span examined in this study, 9.4 percent died within a year after admission.
Patients had an average age of 52, were more often female (54 percent), unmarried (64 percent) and unemployed (78 percent), according to Geisinger data.
Concurrent chronic diseases included cardiovascular disease (22 percent), diabetes (14 percent), cancer (13 percent) and the presence of one or more mental health disorders (35 percent).
Predictors of the worst patient outcomes – including death, repeated overdoses, frequent health care service use and higher related costs – were found to be higher prescription opioid use, having concurrent chronic diseases, having concurrent mental disorders and concurrent use of other psychotropic medications.
"These patients have a history of addiction and other serious mental illness both before and after their overdose, as well as current chronic diseases," said Boscarino.
The research was presented this week in Boston as part of the International Conference on Opioids.