Evidence map›Paper›PMID 33811202›Full record

ArticleThe American journal of gastroenterology2021

Medication Treatment of Active Opioid Use Disorder in Veterans With Cirrhosis.

Shari Rogal, Ada Youk, Olufunso Agbalajobi, Hongwei Zhang, Walid Gellad, Michael J Fine, Pamela Belperio, Timothy Morgan, Chester B Good, Kevin Kraemer

Open access · greenAbstract read
In one paragraph

Article in The American journal of gastroenterology, 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
0.9field-weighted citation impact, top 25% 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

4 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  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

10 authors at 4 institutions in 1 country.

Shari RogalCenter for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
Ada YoukCenter for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
Olufunso AgbalajobiDepartment of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Hongwei ZhangCenter for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
Walid GelladCenter for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
Michael J FineCenter for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
Pamela BelperioDepartment of Veterans Affairs, Palo Alto Health Care System, Palo Alto, California, USA.
Timothy MorganGastroenterology Section, VA Long Beach Healthcare System, Long Beach, California, USA.
Chester B GoodCenter for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
Kevin KraemerCenter for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
University of Pittsburgh · USVA Pittsburgh Healthcare System · USUniversity of California, Irvine · USVA Palo Alto Health Care System · US

Funding

The University of Pittsburgh's Comparative Effectiveness Research Scholars PrograK12HS019461 · AHRQ · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI KAPOOR, WISHWA N · 2010 to 2010
$1.9M
Improving Pain Management and Opioid Safety for Patients with CirrhosisK23DA048182 · NIDA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI ROGAL, SHARI S · 2020 to 2023
$755k
AHRQ HHS K12 HS019461NIDA NIH HHS K23 DA048182
6 · The paper itself

Abstract

introductionAlthough opioid use disorder (OUD) is common in patients with cirrhosis, it is unclear how medication treatment for OUD (MOUD) is used in this population. We aimed to assess the factors associated with MOUD and mortality in a cohort of Veterans with cirrhosis and OUD.

methodsWithin the Veterans Health Administration Corporate Data Warehouse, we developed a cohort of Veterans with cirrhosis and active OUD, using 2 outpatient or 1 inpatient International Classification of Diseases, ninth revision codes from 2011 to 2015 to define each condition. We assessed MOUD initiation with methadone or buprenorphine over the 180 days following the first OUD International Classification of Diseases, ninth revision code in the study period. We fit multivariable regression models to assess the association of sociodemographic and clinical factors with receiving MOUD and the associations between MOUD and subsequent clinical outcomes, including new hepatic decompensation and mortality.

resultsAmong 5,600 Veterans meeting criteria for active OUD and cirrhosis, 722 (13%) were prescribed MOUD over 180 days of follow-up. In multivariable modeling, MOUD was significantly, positively associated with age (adjusted odds ratio [AOR] per year: 1.04, 95% confidence interval (CI): 1.01-1.07), hepatitis C virus (AOR = 2.15, 95% CI = 1.37-3.35), and other substance use disorders (AOR = 1.47, 95% CI = 1.05-2.04) negatively associated with alcohol use disorder (AOR = 0.70, 95% CI = 0.52-0.95), opioid prescription (AOR = 0.51, 95% CI = 0.38-0.70), and schizophrenia (AOR = 0.59, 95% CI = 0.37-0.95). MOUD was not significantly associated with mortality (adjusted hazards ratio = 1.20, 95% CI = 0.95-1.52) or new hepatic decompensation (OR = 0.57, CI = 0.30-1.09). DISCUSSION: Few Veterans with active OUD and cirrhosis received MOUD, and those with alcohol use disorder, schizophrenia, and previous prescriptions for opioids were least likely to receive these effective therapies.

Indexed as

MortalityVeteransAge FactorsAlcoholismAnalgesics, OpioidBuprenorphineCohort StudiesFemaleHepatitis C, ChronicHumansLiver CirrhosisLiver Cirrhosis, AlcoholicMaleMethadoneMiddle AgedMultivariate AnalysisAnalgesics, OpioidBuprenorphineMethadone

Identifiers

PMID33811202
PMCPMC8819871
OpenAlexW3140450717

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.