Evidence map›Paper›PMID 31855919›Full record

ArticleJournal of addiction medicine

Common and Challenging Behaviors Among Individuals on Long-term Opioid Therapy.

Sarah R Young, Soraya Azari, William C Becker, E Jennifer Edelman, Jane M Liebschutz, Payel Roy, Joanna L Starrels, Jessica S Merlin

Open access · greenAbstract read
In one paragraph

Article in Journal of addiction medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.6field-weighted citation impact, top 16% 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

6 citing papers in PubMed, 13 citations in OpenAlex.

  1. Article
  2. Article
  3. Observational
  4. Automatic detection of pain using machine learning.Frontiers in pain research (Lausanne, Switzerland) · 2022
    Article
  5. Article
  6. 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

8 authors at 1 institution in 1 country.

Sarah R YoungDepartment of Social Work, College of Community and Public Affairs, Binghamton University, Binghamton, NY (SRY); University of California, San Francisco, CA (SA); VA Connecticut Healthcare System, West Haven, CT (WCB); Yale School of Medicine, New Haven, CT (WCB, EJE); University of Pittsburgh Department of Medicine, Pittsburgh, PA (JML, JSM); Boston Medical Center, Boston University School of Medicine, Boston, MA (PR); Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY (JLS).
Soraya Azari
William C Becker
E Jennifer Edelman
Jane M Liebschutz
Payel Roy
Joanna L Starrels
Jessica S Merlin
University of Pittsburgh Medical Center · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Yale Drug use, Addiction and HIV Research Scholars (DAHRS)K12DA033312 · NIDA · YALE UNIVERSITY · PI Gail D'Onofrio, Patrick O'Connor · 2013 to 2026
$7.2M
Intervention to Promote Opioid Treatment Agreements in Primary CareK23DA027719 · NIDA · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI STARRELS, JOANNA L. · 2010 to 2014
$909k
Mentoring Junior Investigators to Tackle the Opioid EpidemicK24DA046309 · NIDA · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI STARRELS, JOANNA L. · 2018 to 2023
$876k
Development of a Behavioral Intervention for Chronic Pain in Individuals with HIVK23MH104073 · NIMH · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI MERLIN, JESSICA S · 2015 to 2018
$732k
NCATS NIH HHS UL1 TR001863NIDA NIH HHS K12 DA033312NIDA NIH HHS K23 DA027719NIDA NIH HHS K24 DA046309NIMH NIH HHS K23 MH104073
6 · The paper itself

Abstract

objectiveLong-term opioid therapy (LTOT) is commonly prescribed for chronic pain, despite risks such as opioid use disorder (OUD) and overdose. Caring for patients on LTOT can be difficult, given lack of evidence about assessment of challenging behaviors among patients on LTOT. To develop this evidence, a critical first step is to systematically identify the common and challenging behaviors that primary care providers encounter among patients on LTOT, and also to highlight to diverse range of behaviors encountered.

methodWe conducted a Delphi study in 42 chronic pain experts to determine consensus on how to address the top common and challenging behaviors. This paper reports on the first round of the study, which elicited a range of behaviors. We conducted thematic analysis of the behaviors and also used the Diagnostic and Statistical Manual (DSM)-5 criteria for OUD as a priori codes.

resultsIn all, 124 unique behaviors were identified by participants and coded into 4 thematic categories: concerning behaviors that map onto DSM-5 criteria for OUD, and those that do not which were: behaviors that suggest deception, signs of diversion, and nonadherence to treatment plan. Those behaviors that fell outside of OUD criteria we identified as "gray zone" behaviors.

conclusionsWhile some of these challenging behaviors fall under the criteria for an OUD, many fall outside of this framework, making diagnosis and treatment difficult, and consensus on how to deal with these "gray zone" behaviors is vital. Future research should explore how these "gray zone" behaviors can best be assessed and managed in a primary care setting.

Indexed as

Chronic PainDrug OverdoseOpioid-Related DisordersAnalgesics, OpioidDiagnostic and Statistical Manual of Mental DisordersHumansAnalgesics, Opioid

Identifiers

PMID31855919
PMCPMC7297656
OpenAlexW2994794263

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.