Evidence map›Paper›PMID 30013710›Full record

ArticleThe western journal of emergency medicine2018

Patient Preference for Pain Medication in the Emergency Department Is Associated with Non-fatal Overdose History.

Lauren K Whiteside, Jason Goldstick, Aaron Dora-Laskey, Laura Thomas, Maureen Walton, Rebecca Cunningham, Amy S B Bohnert

Open access · goldAbstract read
In one paragraph

Article in The western journal of emergency medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Lauren K WhitesideUniversity of Washington, Department of Emergency Medicine, Seattle, Washington.
Jason GoldstickUniversity of Michigan Medical School, University of Michigan Injury Center, Ann Arbor, Michigan.
Aaron Dora-LaskeyUniversity of Michigan Medical School, University of Michigan Injury Center, Ann Arbor, Michigan.
Laura ThomasUniversity of Michigan Medical School, Addiction Center and Department of Psychiatry, Ann Arbor, Michigan.
Maureen WaltonUniversity of Michigan Medical School, University of Michigan Injury Center, Ann Arbor, Michigan.
Rebecca CunninghamUniversity of Michigan Medical School, University of Michigan Injury Center, Ann Arbor, Michigan.
Amy S B BohnertUniversity of Michigan Medical School, University of Michigan Injury Center, Ann Arbor, Michigan.
University of Washington · USVA Center for Clinical Management Research · USAnn Arbor VA Medical Center · US

Funding

The Unviersity of Michigan Injury CenterR49CE002099 · CE · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI CUNNINGHAM, REBECCA M. · 2012 to 2018
$5.6M
A longitudinal collaborative care model for patients with prescription opioid misuse utilizing the Emergency Department for careK23DA039974 · NIDA · UNIVERSITY OF WASHINGTON · PI WHITESIDE, LAUREN K · 2015 to 2019
$906k
ACL HHS R49CE002099NIDA NIH HHS K23 DA039974
6 · The paper itself

Abstract

introductionOpioid overdose is a major public health problem. Emergency physicians need information to better assess a patient's risk for overdose or opioid-related harms. The purpose of this study was to determine if patient-reported preference for specific pain medications was associated with a history of lifetime overdose among patients seeking care in the emergency department (ED).

methodsED patients (18-60 years) completed a screening survey that included questions on overdose history, ED utilization, opioid misuse behaviors as measured by the Current Opioid Misuse Measure (COMM), and analgesic medication preferences for previous ED visits for pain with specific responses for preference for hydromorphone (Dilaudid®), morphine, ketorolac (Toradol®), "no preference" or "never visited the ED for pain." We compared individuals who reported a lifetime history of overdose descriptively to those without a lifetime history of overdose. Logistic regression was used to determine factors associated with a history of overdose.

resultsWe included 2,233 adults in the analysis (71.5% response rate of patients approached) with 532 reporting at least one lifetime overdose. In the univariate analysis, medication preference was significantly associated with overdose history (p < .001); more patients in the overdose group reported preferring morphine and hydromorphone and those without a history of overdose were more likely to have no preference or say they had never visited the ED for pain. In the logistic regression analysis, patients with higher odds of overdose included those of Caucasian race, participants with a higher COMM score, preference for ketorolac, morphine or hydromorphone. Those who were younger, female and reported never having visited the ED for pain had lower odds of reporting a lifetime overdose. Having "any preference" corresponded to 48% higher odds of lifetime overdose.

conclusionPatients with a pain medication preference have higher odds of having a lifetime overdose compared to patients without a specific pain medication preference, even after accounting for level of opioid misuse. This patient-reported preference could cue emergency physicians to identifying high-risk patients for overdose and other substance-related harms.

Indexed as

Patient PreferenceAdultAnalgesics, OpioidDrug OverdoseEmergency Service, HospitalFemaleHumansHydromorphoneMaleMiddle AgedMorphinePainAnalgesics, OpioidHydromorphoneMorphine

Identifiers

PMID30013710
PMCPMC6040914
OpenAlexW2810102707

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

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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.