Evidence map›Paper›PMID 34974270›Full record

ArticleDrug and alcohol dependence2022

Impact of transitioning from long-term to intermittent opioid therapy on the development of opioid-related adverse outcomes: A retrospective cohort study.

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

Abstract read
In one paragraph

Article in Drug and alcohol dependence, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. 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.

Corey J HayesDepartment of Biomedical Informatics, College of Medicine, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 782, Little Rock, AR 72205, USA; Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, Bldg. 58, North Little Rock, AR 72114, USA. Electronic address: cjhayes@uams.edu.
Erin E KrebsCenter for Care Delivery and Outcomes Research, Minneapolis VA Healthcare System, 1 Veterans Drive, Minneapolis, MN 55417, USA; Department of Medicine, University of Minnesota Medical School, 401 East River Parkway, VCRC 1st Floor, Suite 131, Minneapolis 55455, USA. Electronic address: kreb0001@umn.edu.
Joshua BrownCenter for Drug Evaluation and Safety, Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, 1225 Center Drive, HPNP #3334, Gainesville, FL 32610, USA. Electronic address: joshua.brown@cop.ufl.edu.
Chenghui LiDivision of Pharmaceutical Evaluation and Policy, College of Pharmacy, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 522, Little Rock, AR 72205, USA. Electronic address: cli@uams.edu.
Teresa HudsonDepartment of Biomedical Informatics, College of Medicine, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 782, Little Rock, AR 72205, USA; Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, Bldg. 58, North Little Rock, AR 72114, USA. Electronic address: hudsontj@uams.edu.
Bradley C MartinDivision of Pharmaceutical Evaluation and Policy, College of Pharmacy, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 522, Little Rock, AR 72205, USA. Electronic address: bmartin@uams.edu.

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

backgroundIncreasing pressures exist to reduce or discontinue opioid use among patients currently on long-term opioid therapy (LTOT). It is essential to understand the potential effects of opioid reduction.

methodsThis retrospective cohort study was conducted among veterans with chronic pain and on LTOT. Using 1:1 propensity score-matched samples of veterans switching to intermittent opioid therapy and those continuing LTOT, we examined the development of subsequent substance use disorders (SUD composite; individual SUD types: opioid, non-opioid drug, and alcohol use disorders) and opioid-related adverse outcomes (ORAO composite; individual ORAO types: accidents resulting in wounds/injuries, opioid-related and alcohol/non-opioid medication-related accidents and overdoses, self-inflicted and violence-related injuries). Sensitivity analyses were conducted using logistic regression with stabilized inverse probability of treatment weighting (SIPTW) and instrumental variable (IV) models.

resultsA total of 29,293 veterans switching to intermittent therapy were matched to veterans continuing LTOT. With matched samples, no differences were found in composite SUDs and ORAOs between the groups. With SIPTW, veterans switching to intermittent opioid therapy had higher odds of composite SUDs and ORAOs (SUDs aOR=1.12, 95%CI: 1.07,1.17; ORAOs aOR=1.05, 95%CI:1.00,1.09). IV models found lower risks for composite SUDs and ORAOs among veterans switching to intermittent opioid therapy (SUDs: β = -0.38, 95%CI:-0.63,-0.13; ORAOs: β = -0.27, 95%CI:-0.50,-0.04).

conclusionsThere were no consistent associations between transitioning patients from LTOT to intermittent opioid therapy and the risk of SUDs and ORAOs.

Indexed as

AlcoholismChronic PainOpioid-Related DisordersAnalgesics, OpioidHumansRetrospective StudiesAnalgesics, OpioidChronic non-cancer painIntermittent opioid therapyLong-term opioid therapyOpioid-related adverse outcomesOpioidsSubstance use disorders

Identifiers

PMID34974270
PMCPMC10041683

What OpenQuestion holds

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Registered trials

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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.