Patient health literacy and the receipt of opioids in the emergency department

Joseph A. Dayaa, MS; Montika Bush, PhD, MS; Natalie L. Richmond, BA; Lewis S. Nelson, MD; Timothy F. Platts-Mills, MD, MSc

doi:10.5055/jom.2019.0511

Authors

Joseph A. Dayaa, MS
Montika Bush, PhD, MS
Natalie L. Richmond, BA
Lewis S. Nelson, MD
Timothy F. Platts-Mills, MD, MSc

DOI:

https://doi.org/10.5055/jom.2019.0511

Keywords:

emergency department, opioid, geriatrics

Abstract

Objective: Assess relationships between patient health literacy and formal education and use of opioids during and following an emergency department (ED) visit.

Design: Prospective, cross-sectional study.

Setting: Academic ED.

Participants: Adults aged ≥ 60 years presenting to the ED with musculoskeletal pain.

Main outcome measures: Opioid use during and after an ED visit.

Results: In a sample of 136 patients, patients with low health literacy were more likely to receive an opioid in the ED than patients with high health literacy (70 percent vs 52 percent; 18 percent difference, 95% confidence interval [CI]: –1 percent, 35 percent), receive an opioid prescription (63 percent vs 44 percent; 19 percent difference, 95% CI: 1 percent, 37 percent), and take opioids during the week following the ED visit (48 percent vs 29 percent; 18 percent difference, 95% CI: 0 percent, 36 percent).

Conclusions: A greater proportion of older adults receiving ED care for musculoskeletal pain with low health literacy receive and use opioids during and following an ED visit.

Author Biographies

Joseph A. Dayaa, MS

Department of Emergency Medicine, University of North Carolina, Chapel Hill, North Carolina

Montika Bush, PhD, MS

Department of Emergency Medicine, University of North Carolina, Chapel Hill, North Carolina

Natalie L. Richmond, BA

School of Medicine, University of North Carolina, Chapel Hill, North Carolina

Lewis S. Nelson, MD

Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, New Jersey

Timothy F. Platts-Mills, MD, MSc

Department of Emergency Medicine, University of North Carolina, Chapel Hill, North Carolina

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