Evidence map›Paper›PMID 30913167›Full record

ArticlePain2019

Analgesic prescribing trends in a national sample of older veterans with osteoarthritis: 2012-2017.

Mark Trentalange, Tessa Runels, Andrew Bean, Robert D Kerns, Matthew J Bair, Abraham A Brody, Cynthia A Brandt, Ula Hwang, EAASE (Evaluating Arthritis Analgesic Safety and Effectiveness) Investigators

Open access · greenAbstract read
In one paragraph

Article in Pain, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
2.0field-weighted citation impact, top 14% 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

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Review
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

9 authors at 4 institutions in 1 country.

Mark TrentalangeDepartment of Anesthesia, James J. Peters Veterans Affairs Medical Center (VAMC), Bronx, NY, United States.
Tessa RunelsGeriatric Research, Education, and Clinical Center (GRECC), James J. Peters VAMC, Bronx, NY, United States.
Andrew BeanGeriatric Research, Education, and Clinical Center (GRECC), James J. Peters VAMC, Bronx, NY, United States.
Robert D KernsPain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, CT, United States.
Matthew J BairVA Center for Health Information and Communication, Indiana University, and Regenstrief Institute, Indianapolis, IN, United States.
Abraham A BrodyGeriatric Research, Education, and Clinical Center (GRECC), James J. Peters VAMC, Bronx, NY, United States.
Cynthia A BrandtPain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, CT, United States.
Ula HwangGeriatric Research, Education, and Clinical Center (GRECC), James J. Peters VAMC, Bronx, NY, United States.
EAASE (Evaluating Arthritis Analgesic Safety and Effectiveness) Investigators
Geriatric Research Education and Clinical Center · USJames J. Peters VA Medical Center · USYale University · USIndiana University School of Medicine

Funding

HSRD VA I01 HX000911
6 · The paper itself

Abstract

Few investigations examine patterns of opioid and nonopioid analgesic prescribing and concurrent pain intensity ratings before and after institution of safer prescribing programs such as the October 2013 Veterans Health Administration system-wide Opioid Safety Initiative (OSI) implementation. We conducted a quasi-experimental pre-post observational study of all older U.S. veterans (≥50 years old) with osteoarthritis of the knee or hip. All associated outpatient analgesic prescriptions and outpatient pain intensity ratings from January 1, 2012 to December 31, 2016, were analyzed with segmented regression of interrupted time series. Standardized monthly rates for each analgesic class (total, opioid, nonsteroidal anti-inflammatory drug, acetaminophen, and other study analgesics) were analyzed with segmented negative binomial regression models with overall slope, step, and slope change. Similarly, segmented linear regression was used to analyze pain intensity ratings and percentage of those reporting pain. All models were additionally adjusted for age, sex, and race. Before OSI implementation, total analgesic prescriptions showed a steady rise, abruptly decreasing to a flat trajectory after OSI implementation. This trend was primarily due to a decrease in opioid prescribing after OSI. Total prescribing after OSI implementation was partially compensated by continuing increased prescribing of other study analgesics as well as a significant rise in acetaminophen prescriptions (post-OSI). No changes in nonsteroidal anti-inflammatory drug prescribing were seen. A small rise in the percentage of those reporting pain but not mean pain intensity ratings continued over the study period with no changes associated with OSI. Changes in analgesic prescribing trends were not paralleled by changes in reported pain intensity for older veterans with osteoarthritis.

Indexed as

AcetaminophenAgedAnalgesicsAnalgesics, Non-NarcoticAnalgesics, OpioidAnti-Inflammatory Agents, Non-SteroidalFemaleHumansMaleMiddle AgedOsteoarthritisPainPractice Patterns, Physicians'VeteransAcetaminophenAnalgesicsAnalgesics, Non-NarcoticAnalgesics, OpioidAnti-Inflammatory Agents, Non-Steroidal

Identifiers

PMID30913167
PMCPMC9486693
OpenAlexW2914929387

What OpenQuestion holds

Textmetadata
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Read underepoch 390

Registered trials

None linked

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.