Author Affiliations: Divisions of Pharmacoepidemiology (Drs Solomon, Rassen, Glynn, and Schneeweiss and Ms Levin) and Rheumatology (Dr Solomon), Brigham and Women's Hospital, Boston, Massachusetts.
Dr Devitt is concerned about the fact that our study follow-up starts the day of the first outpatient dispensing (not prescription). If patients were hospitalized for surgery or an injury and initiated an opioid treatment in the hospital, they would enter our cohort (index date) the day they fill an opioid prescription in the community. Thus, the index date is not the discharge prescription, but it is the first filling of an opioid in the community, which could be the day of discharge or days later. Recent hospitalizations were adjusted for in our multivariate propensity score models.
Solomon DH, Rassen J, Glynn RJ, Levin R, Schneeweiss S. The Comparative Safety of Opioids for Nonmalignant Pain in Older Adults—Reply. Arch Intern Med. 2011;171(15):1401-1404. doi:10.1001/archinternmed.2011.344