Evidence map›Paper›PMID 33948793›Full record

ArticleJournal of general internal medicine2021

Influence of Opioid Prescription Policy on Overdoses and Related Adverse Effects in a Primary Care Population.

Valerie S Harder, Timothy B Plante, Insu Koh, Ethan B Rogers, Susan E Varni, Andrea C Villanti, John R Brooklyn, Kathleen M Fairfield

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
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 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.0field-weighted citation impact, top 24% 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

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. 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 2 institutions in 1 country.

Valerie S HarderDepartment of Pediatrics, The Larner College of Medicine at The University of Vermont, 1 South Prospect Street, Burlington, VT, 05401, USA. Valerie.Harder@uvm.edu.ORCID 0000-0003-2869-2443
Timothy B PlanteDepartment of Medicine, The Larner College of Medicine at The University of Vermont, 89 Beaumont Ave, Burlington, VT, 05405, USA.
Insu KohDepartment of Pathology, The Larner College of Medicine at The University of Vermont, 360 South Park Drive, Colchester, VT, 05446, USA.
Ethan B RogersDepartment of Pediatrics, The Larner College of Medicine at The University of Vermont, 1 South Prospect Street, Burlington, VT, 05401, USA.
Susan E VarniDepartment of Pediatrics, The Larner College of Medicine at The University of Vermont, 1 South Prospect Street, Burlington, VT, 05401, USA.
Andrea C VillantiDepartment of Psychiatry, The Larner College of Medicine at The University of Vermont, 1 South Prospect Street, Burlington, VT, 05401, USA.
John R BrooklynDepartment of Psychiatry, The Larner College of Medicine at The University of Vermont, 1 South Prospect Street, Burlington, VT, 05401, USA.
Kathleen M FairfieldDepartment of Medicine, Maine Medical Center, Portland, Maine, 04102, USA.
University of Vermont · USMaine Medical Center · US

Funding

Understanding Factors Influencing COVID-19 Testing and Vaccination in Immigrant Low-income and Homeless Populations and Testing Targeted InterventionsU54GM115516 · NIGMS · MAINEHEALTH · PI CLIFFORD JAMES ROSEN · 2017 to 2026
$51.6M
Vermont Center on Behavior and HealthP20GM103644 · NIGMS · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI SIGMON, STACEY C · 2013 to 2022
$21.3M
NIGMS NIH HHS P20 GM103644NIGMS NIH HHS U54 GM115516
6 · The paper itself

Abstract

backgroundIn response to the opioid epidemic, many states have enacted policies limiting opioid prescriptions. There is a paucity of evidence of the impact of opioid prescribing interventions in primary care populations, including whether unintended consequences arise from limiting the availability of prescribed opioids.

objectiveOur aim was to compare changes in opioid overdose and related adverse effects rate among primary care patients following the implementation of state-level prescribing policies.

designA cohort of primary care patients within an interrupted time series model.

participantsElectronic medical record data for 62,776 adult (18+ years) primary care patients from a major medical center in Vermont from January 1, 2016, to June 30, 2018.

interventionsState-level opioid prescription policy changes limiting dose and duration. MAIN MEASURES: Changes in (1) opioid overdose rate and (2) opioid-related adverse effects rate per 100,000 person-months following the July 1, 2017, prescription policy change. KEY

resultsAmong primary care patients, there was no change in opioid overdose rate following implementation of the prescribing policy (incidence rate ratio; IRR: 0.64, 95% confidence interval; CI: 0.22-1.88). There was a 78% decrease in the opioid-related adverse effects rate following the prescribing policy (IRR: 0.22, 95%CI: 0.09-0.51). This association was moderated by opioid prescription history, with decreases observed among opioid-naïve patients (IRR: 0.18, 95%CI: 0.06-0.59) and among patients receiving chronic opioid prescriptions (IRR: 0.17, 95%CI: 0.03-0.99), but not among those with intermittent opioid prescriptions (IRR: 0.51, 95%CI: 0.09-2.82).

conclusionsLimiting prescription opioids did not change the opioid overdose rate among primary care patients, but it reduced the rate of opioid-related adverse effects in the year following the state-level policy change, particularly among patients with chronic opioid prescription history and opioid-naïve patients. Limiting the quantity and duration of opioid prescriptions may have beneficial effects among primary care patients.

Indexed as

Analgesics, OpioidPractice Patterns, Physicians'AdultDrug PrescriptionsHumansPolicyPrescriptionsPrimary Health CareVermontAnalgesics, Opioidelectronic medical recordhealthcare utilizationopioidsprescription policyprimary care

Identifiers

PMID33948793
PMCPMC8298594
OpenAlexW3159652031

What OpenQuestion holds

Textmetadata
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.