An evaluation of opioid use during acute hospital admissions

Long-term opioid use can begin with the treatment of acute pain. However, there is little evidence concerning the impact that better opioid awareness in the acute phase may have on reducing the use of opioids in the long term. This project explored which opioids are routinely prescribed within an acute hospital setting and how these opioids were used over the course of the hospital stay. Codeine and morphine remain the most commonly prescribed opioids. Opioids were prescribed and given to people across the age range, from 16 to 98 years. The project found that 19% of patients were admitted with a pre-existing opioid. Up to 66% of patients were discharged with opioid medication, with almost 20% leaving with more than one opioid. Regular opioid use routinely exposes patients to long-term opioid use and those patients initiated onto opioid medication during admission should have the benefit of planned de-escalation before discharge.

Impact of non-medical prescribing

Deborah Robertson provides an overview of recently published articles that may be of interest to non-medical prescribers. Should you wish to look at any of the papers in more detail, a full reference is provided

NYSTATIN

In this column, Sharon Rees aims to refresh knowledge and interest in some of the commonly used drugs in a series of tweets. This month she is talking about #nystatin

The use of pine in a healthcare environment

This month, George Winter discusses the history of using pine in a healthcare setting and how it could still have therapeutic virtues today

Personalisation of DAPT: from ‘bench’ to bedside

The ideal duration of antiplatelet therapy following percutaneous coronary intervention is a topic of much discussion within the cardiology community. Numerous contemporary studies have highlighted benefits of both shortened and prolonged treatment courses within particular patient cohorts. Despite this, there is a delay in seeing such individualised decisions being made within stretched healthcare systems. We aimed to highlight this issue and facilitate discussions on how we can bring this important research from ‘bench’ to ‘bedside’.

Setting up a drug treatment service in a COVID-protect hotel in inner London

At the start of the UK's COVID-19 lockdown, the government announced an ‘Everyone In’ strategy to get homeless people off the streets and into accommodation. An Inner London borough opened a hotel to house up to 100 homeless people to address their health needs. Local healthcare providers were asked to provide in-reach services. This article describes the setting up and delivery of a drug treatment service to provide substitute opioid therapy. Thirty-five people were taken into drug treatment in the hotel between April and December 2020. During this time various challenges had to be addressed including same-day prescribing, delivering and supervising controlled drugs and responding to drug dealing in the hotel. Partnership work between the different healthcare providers was essential for the success of this project and offers a model that could be used going forward to deliver comprehensive wrap-around services to hard-to-engage individuals with multiple health needs.