Evidence map›Paper›PMID 33753317›Full record

ArticleWorld neurosurgery2021

Appropriate Opioid Use After Spine Surgery: Psychobehavioral Barriers and Patient Knowledge.

Rafa Rahman, Sara Wallam, Bo Zhang, Rahul Sachdev, Emmanuel L McNeely, Khaled M Kebaish, Lee H Riley, David B Cohen, Amit Jain, Sang H Lee and 3 more

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World neurosurgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06973655 (Social Worker Presence in Outpatient Fracture Clinics), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.6field-weighted citation impact, top 17% 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.

NCT06973655 narecruitingnot on this mapstarted 2025, after this paper: background citation

Social Worker Presence in Outpatient Fracture Clinics: A Batched Stepped-Wedge Cluster Randomized Trial

TypeinterventionalSponsorSheila SpragueRan2025 to 2028Enrolled2,000ConditionsOrthopaedic Fractures, Socioeconomic FactorsArmsSocial Work support
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 9 citations in OpenAlex.

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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

13 authors at 1 institution in 1 country.

Rafa RahmanDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Sara WallamDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Bo ZhangDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Rahul SachdevDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Emmanuel L McNeelyDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Khaled M KebaishDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Lee H RileyDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
David B CohenDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Amit JainDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Sang H LeeDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Daniel M SciubbaDepartment of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Richard L SkolaskyDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Brian J NeumanDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. Electronic address: bneuman7@jhmi.edu.
Johns Hopkins University · US

Funding

NRSA Training CoreTL1TR003100 · NCATS · JOHNS HOPKINS UNIVERSITY · PI SAHA, SOMNATH · 2019 to 2023
$4.5M
Functional recovery in lumbar spine surgery: Influence of a brief Health BehaviorR01HS017990 · AHRQ · JOHNS HOPKINS UNIVERSITY · PI SKOLASKY, RICHARD L. · 2009 to 2012
$971k
Functional recovery in spinal stenosis: Understanding the activated patientR03HS016106 · AHRQ · JOHNS HOPKINS UNIVERSITY · PI SKOLASKY, RICHARD L · 2006 to 2006
$98k
AHRQ HHS R01 HS017990AHRQ HHS R03 HS016106NCATS NIH HHS TL1 TR003100
6 · The paper itself

Abstract

objectiveTo identify spine patients' barriers to appropriate postoperative opioid use, comfort with naloxone, knowledge of safe opioid disposal practices, and associated factors.

methodsWe preoperatively surveyed 174 spine patients about psychobehavioral barriers to appropriate opioid use, comfort with naloxone, and knowledge about opioid disposal. Multivariable logistic regression identified factors associated with barriers and knowledge (α = 0.05).

resultsCommon barriers were fear of addiction (71%) and concern about disease progression (43%). Most patients (78%) had neutral/low confidence in the ability of nonopioid medications to control pain; most (57%) felt neutral or uncomfortable with using naloxone; and most (86%) were familiar with safe disposal. Anxiety was associated with fear of distracting the physician (adjusted odds ratio [aOR], 3.8; 95% confidence interval [CI], 1.1-14) and with lower odds of knowing safe disposal methods (aOR, 0.18; 95% CI, 0.04-0.72). Opioid use during the preceding month was associated with comfort with naloxone (aOR, 4.9; 95% CI, 2.1-12). Patients with a higher educational level had lower odds of reporting fear of distracting the physician (aOR, 0.30; 95% CI, 0.09-0.97), and those with previous postoperative opioid use had lower odds of concern about disease progression (aOR, 0.25; 95% CI, 0.09-0.63) and with a belief in tolerating pain (aOR, 0.34; 95% CI, 0.12-0.95).

conclusionsMany spine patients report barriers to appropriate postoperative opioid use and are neutral or uncomfortable with naloxone. Some are unfamiliar with safe disposal. Associated factors include anxiety, lack of recent opioid use, and no previous postoperative use.

Indexed as

Health Knowledge, Attitudes, PracticeAdultAgedAnalgesics, OpioidFemaleHumansMaleMiddle AgedNaloxoneNarcotic AntagonistsPostoperative PainSpinal DiseasesAnalgesics, OpioidNaloxoneNarcotic AntagonistsOpioid knowledgePain controlPostoperative opioid use

Identifiers

PMID33753317
PMCPMC8187334
OpenAlexW3137158453

What OpenQuestion holds

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Registered trials

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.