Evidence map›Paper›PMID 32728954›Full record

ArticleJournal of general internal medicine2021

Association Between In-Clinic Opioid Administration and Discharge Opioid Prescription in Urgent Care: a Retrospective Cohort Study.

Susan L Calcaterra, Yingbo Lou, Rachel M Everhart, Lindsey E Fish, Rebecca Hanratty

Open access · bronzeAbstract read
In one paragraph

Article in Journal of general internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.5field-weighted citation impact, top 29% 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

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. 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

5 authors at 2 institutions in 1 country.

Susan L CalcaterraDivision of General Internal Medicine, Department of Medicine, University of Colorado, Aurora, CO, USA. Susan.calcaterra@cuanschutz.edu.ORCID http://orcid.org/0000-0002-0584-7783
Yingbo LouAmbulatory Care Services, Denver Health Medical Center, Denver, CO, USA.
Rachel M EverhartDivision of General Internal Medicine, Department of Medicine, University of Colorado, Aurora, CO, USA.
Lindsey E FishDivision of General Internal Medicine, Department of Medicine, University of Colorado, Aurora, CO, USA.
Rebecca HanrattyDivision of General Internal Medicine, Department of Medicine, University of Colorado, Aurora, CO, USA.
Denver Health Medical Center · USUniversity of Colorado Anschutz Medical Campus · US

Funding

Understanding Factors that Limit Access to Opioid Use Disorder Treatment in the Hospital to Inform Innovative Approaches to Expand Hospital-Based TreatmentK08DA049905 · NIDA · UNIVERSITY OF COLORADO DENVER · PI CALCATERRA, SUSAN L · 2020 to 2024
$945k
NIDA NIH HHS K08 DA049905
6 · The paper itself

Abstract

backgroundEmergency departments increasingly use nonopioid analgesics to manage acute pain and minimize opioid-related harms. Urgent care centers are expanding to lower costs and provide efficient access to healthcare. General internists increasingly work in these acute care settings. Much is known about opioid prescribing in the primary care, inpatient, and emergency department setting. Little is known about opioid prescribing in the urgent care setting and associated outcomes.

objectivesTo assess the association between in-clinic opioid administration and opioid receipt at clinic discharge and on progression to chronic opioid use among urgent care patients.

designRetrospective cohort study.

participantsPatients, 20 years or older and not on opioid medications, who presented for care to an urgent care clinic within a safety-net healthcare system from June 1, 2016, to April 30, 2019. MAIN MEASURES: We examined the association between the in-clinic administration of oral or intravenous opioids and opioid receipt at clinic discharge. We also examined the association between in-clinic opioid administration and progression to chronic opioid use after six months. KEY

resultsThe study sample included 34,978 patients, of which 13.8% (n = 4842) received in-clinic opioids and 86.2% (n = 30,136) did not receive in-clinic opioids. After adjusting for age, gender, race/ethnicity, insurance, and pain diagnosis, patients who received in-clinic opioids were more likely to receive opioids at discharge compared to patients who did not receive in-clinic opioids (aOR = 12.30, 95% CI 11.44-13.23). Among a selected cohort of patients, in-clinic opioid administration was associated with progression to chronic opioid use (aOR = 2.12, 95% CI 1.66-2.71).

conclusionsIn-clinic opioid administration was strongly associated with opioid receipt at discharge and progression to chronic opioid use. Increased use of nonopioid analgesics in urgent care could likely reduce this association and limit opioids available for diversion, overdose, and death.

Indexed as

Analgesics, OpioidPatient DischargeAmbulatory CareHumansPractice Patterns, Physicians'PrescriptionsRetrospective StudiesAnalgesics, Opioidacute painopioidsurgent care

Identifiers

PMID32728954
PMCPMC7859130
OpenAlexW3045772182

What OpenQuestion holds

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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.