ArticleJournal of opioid management
Guideline adherence and reasons for recommending dose reduction in a primary care-based opioid management clinic.
Article in Journal of opioid management. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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.
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Who cites it
1 citing paper in PubMed, 1 citations in OpenAlex.
- "I Am Reluctant to Continue, Yet Know She Could Go into Withdrawal": A Qualitative Analysis of Clinician Requests for eConsults in Opioid Management in the Ambulatory Setting.Journal of general internal medicine · 2026Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundTo provide Centers for Disease Control and Prevention (CDC) guideline-recommended practices for patients on long-term opioid therapy (LTOT) including individualized decisions about opioid dose reduction, we developed the Power Over Pain (POP) Clinic.
objectiveTo describe frequency and reasons for opioid dose reduction and pre-post adherence to CDC guideline-recommended practices.
designRetrospective chart review with qualitative and pre-post analysis. PATIENTS AND
settingPatients at an urban internal medicine teaching practice-prescribed LTOT were seen at POP Clinic at least once.
methodsOpioid dose reduction was defined by reduction in morphine-equivalent daily dose (MEDD) at 6 and 12 months after the first POP Clinic visit compared to baseline using paired t-tests. Among patients with a dose reduction, reasons documented in POP Clinic notes were qualitatively examined. Dichotomous measures of receiving four CDC guideline-recommended practices (controlled substance agreement [CSA], urine drug testing [UDT], prescription monitoring program review, and naloxone dispensing) at baseline versus 6 and 12 months were compared using McNemar's tests.
resultsOf the 70 patients, most were female (66 percent) and Hispanic (54 percent). Forty-three patients (61 percent) had an opioid dose reduction in 12 months after the first POP Clinic visit. The most frequent reason was low or unclear benefit of continuing the current dose (49 percent). Mean MEDD was reduced from 69 mg to 57 mg at 6 months (p < 0.01) and to 56 mg at 12 months (p < 0.01). Completing a CSA, UDT, and naloxone distribution increased at 6 and 12 months (p < 0.01).
conclusionsIndividualized risk assessment in a primary care-based opioid management clinic is feasible and can result in opioid dose reduction and guideline adherence.
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Registered trials
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