Evidence map›Paper›PMID 33518026›Full record

ArticleValue in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research2021

Association Between Dual Trajectories of Opioid and Gabapentinoid Use and Healthcare Expenditures Among US Medicare Beneficiaries.

Lili Zhou, Sandipan Bhattacharjee, C Kent Kwoh, Daniel C Malone, Patrick J Tighe, Gary M Reisfield, Marion Slack, Debbie L Wilson, Wei-Hsuan Lo-Ciganic

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In one paragraph

Article in Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Article
  2. Hierarchical Concept Relations Improve Detection of Off-Label Drug Use in Electronic Health Records Data.AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science · 2023
    Article
  3. Article
  4. 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

9 authors.

Lili ZhouDepartment of Pharmacy Practice and Science, University of Arizona, Tucson, AZ, USA; University of Arizona Arthritis Center, Tucson, AZ, USA.
Sandipan BhattacharjeeHealth Outcome Division, University of Texas at Austin, Austin, Texas, USA.
C Kent KwohUniversity of Arizona Arthritis Center, Tucson, AZ, USA; Department of Medicine, University of Arizona, Tucson, AZ, USA.
Daniel C MaloneDepartment of Pharmacotherapy, University of Utah, Salt Lake City, UT, USA.
Patrick J TigheDepartment of Anesthesiology, University of Florida, Gainesville, FL, USA.
Gary M ReisfieldDivisions of Addiction Medicine & Forensic Psychiatry, Departments of Psychiatry & Anesthesiology, University of Florida, Gainesville, FL, USA.
Marion SlackDepartment of Pharmacy Practice and Science, University of Arizona, Tucson, AZ, USA.
Debbie L WilsonDepartment of Pharmaceutical Outcomes and Policy, University of Florida, Gainesville, FL, USA.
Wei-Hsuan Lo-CiganicDepartment of Pharmaceutical Outcomes and Policy, University of Florida, Gainesville, FL, USA; Center for Drug Evaluation and Safety, University of Florida, Gainesville, FL, USA. Electronic address: wlociganic@cop.ufl.edu.

Funding

Finding Good TEMporal PostOperative pain Signatures (TEMPOS)R01GM114290 · NIGMS · UNIVERSITY OF FLORIDA · PI TIGHE, PATRICK J · 2015 to 2019
$2.5M
Using a predicting Risky Opioid-Benzodiazepine Trajectory e-Care Tool (PROTeCT) to identify high-risk regionsR21AG060308 · NIA · UNIVERSITY OF FLORIDA · PI LO-CIGANIC, WEI-HSUAN · 2019 to 2020
$523k
NIA NIH HHS R21 AG060308NIGMS NIH HHS R01 GM114290
6 · The paper itself

Abstract

objectivesLittle is known about relationships between opioid- and gabapentinoid-use patterns and healthcare expenditures that may be affected by pain management and risk of adverse outcomes. This study examined the association between patients' opioid and gabapentinoid prescription filling/refilling trajectories and direct medical expenditures in US Medicare.

methodsThis cross-sectional study included a 5% national sample (2011-2016) of fee-for-service beneficiaries with fibromyalgia, low back pain, neuropathy, or osteoarthritis newly initiating opioids or gabapentinoids. Using group-based multitrajectory modeling, this study identified patients' distinct opioid and gabapentinoid (OPI-GABA) dose and duration patterns, based on standardized daily doses, within a year of initiating opioids and/or gabapentinoids. Concurrent direct medical expenditures within the same year were estimated using inverse probability of treatment weighted multivariable generalized linear regression, adjusting for sociodemographic and health status factors.

resultsAmong 67 827 eligible beneficiaries (mean age ± SD = 63.6 ± 14.8 years, female = 65.8%, white = 77.1%), 11 distinct trajectories were identified (3 opioid-only, 4 gabapentinoid-only, and 4 concurrent OPI-GABA trajectories). Compared with opioid-only early discontinuers ($13 830, 95% confidence interval = $13 643-14 019), gabapentinoid-only early discontinuers and consistent low-dose and moderate-dose gabapentinoid-only users were associated with 11% to 23% lower health expenditures (adjusted mean expenditure = $10 607-$11 713). Consistent low-dose opioid-only users, consistent high-dose opioid-only users, consistent low-dose OPI-GABA users, consistent low-dose opioid and high-dose gabapentinoid users, and consistent high-dose opioid and moderate-dose gabapentinoid users were associated with 14% to 106% higher healthcare expenditures (adjusted mean expenditure = $15 721-$28 464).

conclusionsDose and duration patterns of concurrent OPI-GABA varied substantially among fee-for-service Medicare beneficiaries. Consistent opioid-only users and all concurrent OPI-GABA users were associated with higher healthcare expenditures compared to opioid-only discontinuers.

Indexed as

AgedAged, 80 and overAnalgesicsAnalgesics, OpioidCross-Sectional StudiesDrug UtilizationFee-for-Service PlansFemaleGabapentinHumansMaleMedicareMiddle AgedPainUnited StatesAnalgesicsAnalgesics, OpioidGabapentingabapentinoidshealth expendituresMedicareopioidstrajectories

Identifiers

PMID33518026
PMCPMC8359825

What OpenQuestion holds

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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.