Evidence map›Paper›PMID 31251985›Full record

Observational studyOsteoarthritis and cartilage2019

Patterns of prescription opioid use before total hip and knee replacement among US Medicare enrollees.

Y Jin, D H Solomon, P D Franklin, Y C Lee, J Lii, J N Katz, S C Kim

Open access · greenAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Osteoarthritis and cartilage, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
6.2field-weighted citation impact, top 3% 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

10 citing papers in PubMed, 41 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Opioid Use and Total Joint Replacement.Current rheumatology reports · 2020
    Review
  10. 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 2 institutions in 1 country.

Y JinDivision of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: yjin9@bwh.harvard.edu.
D H SolomonDivision of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: dsolomon@bwh.harvard.edu.
P D FranklinDepartment of Medical Social Sciences, Northwestern University, Chicago, IL, USA. Electronic address: patricia.franklin@northwestern.edu.
Y C LeeFeinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: yvonne.lee@northwestern.edu.
J LiiDivision of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: jlii@bwh.harvard.edu.
J N KatzBrigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: jnkatz@bwh.harvard.edu.
S C KimDivision of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: sykim@bwh.harvard.edu.
Brigham and Women's Hospital · USNorthwestern University · US

Funding

Use and safety of opioids in patients undergoing total joint replacementR01AR069557 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI KIM, SEOYOUNG CATHERINE · 2016 to 2019
$2.2M
NIAMS NIH HHS R01 AR069557
6 · The paper itself

Abstract

objectiveTo examine patterns of prescription opioid use before total joint replacement (TJR) and factors associated with continuous use of opioids before TJR.

designWe conducted an observational cohort study among Medicare enrollees aged ≥65 years who underwent TJR between 2010 and 2014. Preoperative opioid use was defined as having any opioid prescription in the 12-month period before TJR. Patients who had an opioid prescription every month for a 12-month period were defined as continuous users. We examined patients' demographics, pain-related conditions, medication use, other comorbidities, healthcare utilization and their association with use of opioids before TJR.

resultsA total of 473,781 patients underwent TJR:,155,516 THR and 318,265 TKR. Among the total cohort, 60.2% patients had any use of opioids and of those, 12.4% used opioids at least once a month continuously over the 12-month baseline period. Correlates of continuous opioid use included African American race (OR = 2.14, 95% confidence intervals (CI) = 2.01-2.28, compared to White patients), history of drug abuse (OR = 5.18, 95% CI = 3.95-6.79) and back pain (OR = 2.32, 95% CI = 2.24-2.39).

conclusionsIn this large cohort of patients undergoing TJR, over 60% ever used opioids and 12.4% of them continuously used opioids in the 12-month prior to surgery. Utilization of opioids became more frequent and high-dosed near the surgery. History of drug abuse, back pain, and African American race were strongly associated with continuous use of opioids preoperatively. Further research is needed to determine short-term and long-term risks of preoperative use of opioids in TJR patients and to optimize pre- and post-TJR pain management of patients with arthritis.

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneeAgedAged, 80 and overAnalgesics, OpioidArthralgiaCohort StudiesDrug PrescriptionsFemaleHumansMaleMedicareOsteoarthritis, HipOsteoarthritis, KneePreoperative CareUnited StatesAnalgesics, OpioidOpioidsOsteoarthritisTotal joint replacement

Identifiers

PMID31251985
PMCPMC6751003
OpenAlexW2954525346

What OpenQuestion holds

Textmetadata
LicenceTDM
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.