Evidence map›Paper›PMID 34186177›Full record

ArticleThe journal of pain2021

Association Between Pain Intensity and Discontinuing Opioid Therapy or Transitioning to Intermittent Opioid Therapy After Initial Long-Term Opioid Therapy: A Retrospective Cohort Study.

Corey J Hayes, Erin E Krebs, Joshua Brown, Chenghui Li, Teresa Hudson, Bradley C Martin

Open access · greenAbstract read
In one paragraph

Article in The journal of pain, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 26% 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, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Cannabinoids and opioid consumption in cancer pain: a systematic review and meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Pooled it
  2. Trial
  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

6 authors at 4 institutions in 1 country.

Corey J HayesCenter for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas; Center for Health Services Research, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Erin E KrebsCenter for Care Delivery and Outcomes Research, Minneapolis VA Healthcare System, 1 Veterans Dr, Minneapolis, Minneapolis; College of Medicine, University of Minnesota, Minneapolis, Minneapolis.
Joshua BrownDepartment of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida.
Chenghui LiDivision of Pharmaceutical Evaluation and Policy, College of Pharmacy, University of Arkansas for Medical Sciences, Arkansas.
Teresa HudsonCenter for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas; Center for Health Services Research, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Bradley C MartinDivision of Pharmaceutical Evaluation and Policy, College of Pharmacy, University of Arkansas for Medical Sciences, Arkansas. Electronic address: bmartin@uams.edu.
University of Arkansas for Medical Sciences · USCentral Arkansas Veterans Healthcare System · USUniversity of Florida · USUniversity of Minnesota · US

Funding

Translational Training in AddictionT32DA022981 · NIDA · UNIV OF ARKANSAS FOR MED SCIS · PI Melissa Jean Zielinski · 2009 to 2026
$6.1M
Impact of Opioid Dosing Strategies on Pain Scores and Adverse or Unintended Clinical OutcomesR36DA046717 · NIDA · UNIV OF ARKANSAS FOR MED SCIS · PI HAYES, COREY J · 2018 to 2018
$54k
NIDA NIH HHS R36 DA046717NIDA NIH HHS T32 DA022981
6 · The paper itself

Abstract

The purpose of this study was to evaluate changes in pain intensity among Veterans transitioning from long-term opioid therapy (LTOT) to either intermittent therapy or discontinuation compared to continued LTOT. Pain intensity was assessed using the Numeric Rating Scale in 90-day increments starting in the 90-day period prior to potential opioid transitions and the two ensuing 90-day periods after transition. Primary analyses used a 1:1 greedy propensity matched sample. A total of 29,293 Veterans switching to intermittent opioids and 5,972 discontinuing opioids were matched to Veterans continuing LTOT. Covariates were well balanced after matching except minor differences in baseline mean pain scores. Pain scores were lower in the follow up periods for those switching to intermittent opioids and discontinuing opioids compared to those continuing LTOT (0-90 days: Intermittent: 3.79, 95%CI: 3.76, 3.82; LTOT: 4.09, 95%CI: 4.06, 4.12, P < .0001; Discontinuation: 3.06, 95%CI: 2.99, 3.13; LTOT: 3.86, 95%CI: 3.79, 3.94, P = <.0001; 91-180 days: Intermittent: 3.76, 95%CI: 3.73, 3.79; LTOT: 3.99, 95%CI: 3.96, 4.02, P < .0001; Discontinuation: 3.01, 95%CI: 2.94, 3.09; LTOT: 3.80, 95%CI: 3.73, 3.87, P = <.0001). Sensitivity analyses found similar results. Discontinuing opioid therapy or switching to intermittent opioid therapy was not associated with increased pain intensity. PERSPECTIVE: This article evaluates the association of switching to intermittent opioid therapy or discontinuing opioids with pain intensity after using opioids long-term. Pain intensity decreased after switching to intermittent therapy or discontinuing opioids, but remained relatively stable for those continuing long-term opioid therapy. Switching to intermittent opioids or discontinuing opioids was not associated with increased pain intensity.

Indexed as

Outcome Assessment, Health CareAdultAgedAnalgesics, OpioidChronic PainFemaleFollow-Up StudiesHumansMaleMiddle AgedPain MeasurementRetrospective StudiesVeteransAnalgesics, Opioidchronic opioid discontinuationintermittent opioid useNumeric Rating Scaleopioidspain intensitypain scores

Identifiers

PMID34186177
PMCPMC10068896
OpenAlexW3175283297

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.