ArticleJournal of general internal medicine2010
Relationship of opioid use and dosage levels to fractures in older chronic pain patients.
Article in Journal of general internal medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05525975 (The Impact of Pre-operative Opioid Education and Opioid Disposal Following Shoulder Arthroplasty), which is not on this map. Cited by 140 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Impact of Pre-operative Opioid Education and Opioid Disposal Following Shoulder Arthroplasty
Who cites it
140 citing papers in PubMed, 7 syntheses or guidelines pooled it, 277 citations in OpenAlex.
- Perioperative interventions to improve early mobilisation and physical function after hip fracture: a systematic review and meta-analysis.Age and ageing · 2023Pooled it
- Peripheral nerve blocks for hip fractures in adults.The Cochrane database of systematic reviews · 2020Pooled it
- Pooled it
- Cognitive Behavioral Therapy (CBT) for Subacute Low Back Pain: a Systematic Review.Current pain and headache reports · 2018Pooled it
- Peripheral nerve blocks for hip fractures.The Cochrane database of systematic reviews · 2017Pooled it
- [Long-term opioid therapy in chronic noncancer pain. A systematic review and meta-analysis of efficacy, tolerability and safety in open-label extension trials with study duration of at least 26 weeks].Schmerz (Berlin, Germany) · 2015Pooled it
- Pooled it
- Trial
- Emotional Awareness and Expression Therapy vs Cognitive Behavioral Therapy for Chronic Pain in Older Veterans: A Randomized Clinical Trial.JAMA network open · 2024Trial
- A Cluster-Randomized Clinical Trial to Decrease Prescription Opioid Misuse: Improving the Safety of Opioid Therapy (ISOT).Journal of general internal medicine · 2022Trial
- Association of Opioid Consumption Profiles After Hospitalization With Risk of Adverse Health Care Events.JAMA network open · 2021Trial
- Study of Individualization and Bias in Nursing Home Fall Prevention Practices.Journal of the American Geriatrics Society · 2017Trial
- Trial
- Prenatal Opioid Exposure and Subsequent Risk of Fractures in Children: An Emulated Target Trial Using a Nationwide Birth Cohort.Indian pediatrics · 2026Article
- Incidence and duration of hospital-initiated opioids, benzodiazepines and antipsychotics: a retrospective cohort study.International journal of clinical pharmacy · 2026Article
- Association Between Diagnostic Imaging, Medication Intake, and Health Outcomes in Chronic Whiplash-Associated Disorders: An Observational Study.Physiotherapy Canada. Physiotherapie Canada · 2026Article
- The accuracy and reliability of patient-reported opioid consumption following surgical fracture management.Pain reports · 2026Article
- Factors associated with long-term opioid therapy discontinuation for people with chronic non-cancer pain in UK primary care: a population-based retrospective cohort study.British journal of anaesthesia · 2026Article
- Psychiatric, Cardiovascular and Skeletal Risks of Codeine versus Oxycodone in Hip Osteoarthritis: A Population-Based Cohort Study.Drug design, development and therapy · 2026Article
- Article
80 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundOpioids have been linked to increased risk of fractures, but little is known about how opioid dose affects fracture risk.
objectiveTo assess whether risk of fracture increases with opioid dose among older patients initiating sustained use of opioids for chronic non-cancer pain.
designA cohort study that uses Cox proportional hazards models to compare fracture risk among current opioid users vs. persons no longer using opioids.
participantsMembers of an integrated health care plan (N = 2,341) age 60 years and older who received 3+ opioid prescriptions within a 90-day period for chronic, non-cancer pain between 2000 and 2005. MEASUREMENTS: Time-varying measures of opioid use and average daily dose in morphine equivalents were calculated from automated data. Fractures were identified from automated data and then validated through medical record review.
resultsCompared with persons not currently using opioids, opioid use was associated with a trend towards increased fracture risk (1.28 (95% CI (0.99, 1.64 )). Higher dose opioid use (>or=50 mg/day) was associated with a 9.95% annual fracture rate and a twofold increase in fracture risk (2.00 (95% CI (1.24, 3.24)). Of the fractures in the study cohort, 34% were of the hip or pelvis, and 37% were associated with inpatient care.
conclusionsHigher doses (>or=50 mg/day) of opioids for chronic non-cancer pain were associated with a 2.00 increase in risk of fracture confirmed by medical record review. Clinicians should consider fracture risk when prescribing higher-dose opioid therapy for older adults.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.