ArticlePloS one2021
Characteristics of opioid prescribing to outpatients with chronic liver diseases: A call for action.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 7 citations in OpenAlex.
- Urinary incontinence in older adults: call for action in geriatric care and research.European geriatric medicine · 2026Article
- Hepatic Encephalopathy: Current Thoughts on Pathophysiology and Management.Current neurology and neuroscience reports · 2025Review
- Association of prior opium addiction with incident non-alcoholic fatty liver disease: A case-control study.PloS one · 2025Article
- Changing Epidemiology of Cirrhosis and Hepatic Encephalopathy.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2022Review
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundChronic liver disease (CLD) is among the strongest risk factors for adverse prescription opioid-related events. Yet, the current prevalence and factors associated with high-risk opioid prescribing in patients with chronic liver disease (CLD) remain unclear, making it challenging to address opioid safety in this population. Therefore, we aimed to characterize opioid prescribing patterns among patients with CLD.
methodsThis retrospective cohort study included patients with CLD identified at a single medical center and followed for one year from 10/1/2015-9/30/2016. Multivariable, multinomial regression was used identify the patient characteristics, including demographics, medical conditions, and liver-related factors, that were associated with opioid prescriptions and high-risk prescriptions (≥90mg morphine equivalents per day [MME/day] or co-prescribed with benzodiazepines).
resultsNearly half (47%) of 12,425 patients with CLD were prescribed opioids over a one-year period, with 17% of these receiving high-risk prescriptions. The baseline factors significantly associated with high-risk opioid prescriptions included female gender (adjusted incident rate ratio, AIRR = 1.32, 95% CI = 1.14-1.53), Medicaid insurance (AIRR = 1.68, 95% CI = 1.36-2.06), cirrhosis (AIRR = 1.22, 95% CI = 1.04-1.43) and baseline chronic pain (AIRR = 3.40, 95% CI = 2.94-4.01), depression (AIRR = 1.93, 95% CI = 1.60-2.32), anxiety (AIRR = 1.84, 95% CI = 1.53-2.22), substance use disorder (AIRR = 2.16, 95% CI = 1.67-2.79), and Charlson comorbidity score (AIRR = 1.27, 95% CI = 1.22-1.32). Non-alcoholic fatty liver disease was associated with decreased high-risk opioid prescriptions (AIRR = 0.56, 95% CI = 0.47-0.66).
conclusionOpioid medications continue to be prescribed to nearly half of patients with CLD, despite efforts to curtail opioid prescribing due to known adverse events in this population.
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