ArticleJournal of the American Geriatrics Society2017
Opioids and Other Central Nervous System-Active Polypharmacy in Older Adults in the United States.
Article in Journal of the American Geriatrics Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05037682 (Addressing Opioid Use Disorder in the Elderly Through Primary Care Innovation), which is not on this map. Cited by 36 papers.
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.
Addressing Opioid Use Disorder in the Elderly Through Primary Care Innovation: Pain and Opioid Management in Older Adults
Who cites it
36 citing papers in PubMed, 81 citations in OpenAlex.
- The Benefits ofJournal of alternative and complementary medicine (New York, N.Y.) · 2020Trial
- Racial disparities and trends in anticoagulant use among ambulatory care patients with atrial fibrillation and atrial flutter in the United States from 2007 to 2019.BMC health services research · 2025Article
- Disparities in diagnosis and management of chronic overlapping pain conditions in an observational study of medicare beneficiaries.The journal of pain · 2025Observational
- Development of the barriers to opioid access scale among individuals with chronic pain.Exploratory research in clinical and social pharmacy · 2025Article
- Epidemiological Aspects and Pattern of Intoxication among Elderly in Khorasan-Razavi; Northeast of Iran.Journal of prevention (2022) · 2025Article
- The burden of acute pain in the U.S. in the wake of the opioid crisis.Frontiers in pain research (Lausanne, Switzerland) · 2025Review
- Trends in central nervous system-active polypharmacy among people with multiple sclerosis.Multiple sclerosis (Houndmills, Basingstoke, England) · 2024Article
- Chronic Pain Self-Management Strategies for Older Adults: An Integrative Review.Life (Basel, Switzerland) · 2024Review
- Prevalence and trend of central nervous system-active medication polypharmacy among US commercially insured adults with vs without early-onset dementia: a multi-year cross-sectional study.Alzheimer's research & therapy · 2024Article
- Diagnosis of frailty and implications on surgical process in the elderly: A narrative review.European journal of anaesthesiology and intensive care · 2023Review
- Patient Perceptions of Opioids and Benzodiazepines and Attitudes Toward Deprescribing.Drugs & aging · 2023Article
- Association of medication use with falls and mortality among long-term care residents: a longitudinal cohort study.BMC geriatrics · 2023Article
- Pharmacist interventions to deprescribe opioids and benzodiazepines in older adults: A rapid review.Research in social & administrative pharmacy : RSAP · 2022Review
- Frailty Risks of Prescription Analgesics and Sedatives across Frailty Models: the Health and Retirement Study.Drugs & aging · 2022Article
- Opioid Drug-Drug-Drug Interactions and Unintentional Traumatic Injury: Screening to Detect Three-Way Drug Interaction Signals.Frontiers in pharmacology · 2022Article
- The impact of high-risk medications on mortality risk among older adults with polypharmacy: evidence from the English Longitudinal Study of Ageing.BMC medicine · 2021Article
- Chronic Pain, Opioid Use Disorder, and Clinical Management Among Older Adults.Focus (American Psychiatric Publishing) · 2021Article
- Low Back Pain and Substance Use: Diagnostic and Administrative Coding for Opioid Use and Dependence Increased in U.S. Older Adults with Low Back Pain.Pain medicine (Malden, Mass.) · 2021Article
- Quality of opioid prescribing in older adults with or without Alzheimer disease and related dementia.Alzheimer's research & therapy · 2021Article
- Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesTo determine patterns of and trends in contributions to central nervous system (CNS) polypharmacy, defined by the Beers Criteria as three or more CNS-active medications of each medication class, of adults aged 65 and older seen in U.S. outpatient medical practices.
designNational Ambulatory Medical Care Survey (2004-2013).
settingU.S. outpatient medical care.
participantsVisits by older adults to outpatient physicians (N = 97,910). MEASUREMENTS: Visits including three or more CNS medications including antipsychotics, benzodiazepines, nonbenzodiazepine benzodiazepine receptor agonist hypnotics (NBRAs), tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), and opioids. The proportion of CNS polypharmacy that each medication class contributed during 2011 to 2013 was determined, and then logistic regression was used to determine trends from 2004 to 2013 in the contribution of individual medication classes to such polypharmacy.
resultsOf recent CNS polypharmacy visits, 76.2% included an opioid, and 61.8% included a benzodiazepine; 66.0% of the polypharmacy visits with benzodiazepines included opioids, and 53.3% of the polypharmacy visits with opioids included benzodiazepines. Between 2011 and 2013, opioid and benzodiazepine co-prescribing occurred at approximately 1.50 million visits (95% confidence interval (CI) = 1.23-1.78 million) annually. From 2004 (reference) to 2013, the proportion of polypharmacy visits with opioids rose from 69.6% to 76.2% (adjusted odds ratio = 2.15, 95% CI = 1.19-3.91, P = .01), and the corresponding proportion that included benzodiazepines fell. Of the polypharmacy visits, the odds of SSRI, NBRA, and antipsychotic use were unchanged, and that of TCAs decreased.
conclusionIn older adults, opioid use appears to be largely driving the recent national increase in CNS polypharmacy. Although concomitant use of opioids and benzodiazepines is associated with greater mortality, they are the most common contributors to CNS polypharmacy in 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.