Evidence map›Paper›PMID 35367681›Full record

ArticleThe American journal of emergency medicine2022

Patterns of opioid prescribing in emergency departments during the early phase of the COVID-19 pandemic.

Tucker Lurie, Naomi Bonnin, Jeffrey Rea, Gurshawn Tuteja, Zachary Dezman, R Gentry Wilkerson, Adelina Buganu, Rose Chasm, Daniel J Haase, Quincy K Tran

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The American journal of emergency medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.8field-weighted citation impact, top 16% 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, 12 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Review
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

10 authors at 1 institution in 1 country.

Tucker LurieWellspan York Hospital, Department of Emergency Medicine, 1001 South George Street, York, PA, 17403, USA. Electronic address: tlurie@wellspan.org.
Naomi BonninUniversity of Maryland Global Campus, 1616 McCormick Dr, Largo, MD 20774, USA.
Jeffrey ReaUniversity of Maryland School of Medicine, 655 West Baltimore Street, Baltimore, MD 21201, USA; Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA; Program in Trauma, The R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD 21201, USA. Electronic address: jrea@umm.edu.
Gurshawn TutejaMedical College of Georgia, 1120 15th St, Augusta, GA 30912, USA. Electronic address: GTUTEJA@augusta.edu.
Zachary DezmanUniversity of Maryland School of Medicine, 655 West Baltimore Street, Baltimore, MD 21201, USA; Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA. Electronic address: ZDezman@som.umaryland.edu.
R Gentry WilkersonUniversity of Maryland School of Medicine, 655 West Baltimore Street, Baltimore, MD 21201, USA; Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA. Electronic address: Gwilkerson@som.umaryland.edu.
Adelina BuganuUniversity of Maryland School of Medicine, 655 West Baltimore Street, Baltimore, MD 21201, USA; Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA.
Rose ChasmUniversity of Maryland School of Medicine, 655 West Baltimore Street, Baltimore, MD 21201, USA; Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA. Electronic address: Rchasm@som.umaryland.edu.
Daniel J HaaseUniversity of Maryland School of Medicine, 655 West Baltimore Street, Baltimore, MD 21201, USA; Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA; Program in Trauma, The R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD 21201, USA. Electronic address: DHaase@som.umaryland.edu.
Quincy K TranUniversity of Maryland School of Medicine, 655 West Baltimore Street, Baltimore, MD 21201, USA; Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA; Program in Trauma, The R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD 21201, USA; The Research Associate Program in Emergency Medicine & Critical Care, University of Maryland School of Medicine, 22 South Greene Street, suite P1G01, Baltimore, MD 21201, USA. Electronic address: Qtran@som.umaryland.edu.
McCormick (United States) · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe COVID-19 pandemic was superimposed upon an ongoing epidemic of opioid use disorder and overdose deaths. Although the trend of opioid prescription patterns (OPP) had decreased in response to public health efforts before the pandemic, little is known about the OPP from emergency department (ED) clinicians during the COVID-19 pandemic.

methodsWe conducted a pre-post study of adult patients who were discharged from 13 EDs and one urgent care within our academic medical system between 01/01/2019 and 09/30/2020 using an interrupted time series (ITS) approach. Patient characteristics and prescription data were extracted from the single unified electronic medical record across all study sites. Prescriptions of opioids were converted into morphine equivalent dose (MED). We compared the "Covid-19 Pandemic" period (C19, 03/29/2020-9/30/2020) and the "Pre-Pandemic" period (PP, 1/19/2020-03/28/2020). We used a multivariate logistic regression to assess clinical factors associated with opioid prescriptions.

resultsWe analyzed 361,794 ED visits by adult patients, including 259,242 (72%) PP and 102,552 (28%) C19 visits. Demographic information and percentages of patients receiving opioid prescriptions were similar in both groups. The median [IQR] MED per prescription was higher for C19 patients (70 [56-90]) than for PP patients (60 [60-90], P < 0.001). ITS demonstrated a significant trend toward higher MED prescription per ED visit during the pandemic (coefficient 0.11, 95% CI 0.05-0.16, P = 0.002). A few factors, that were associated with lower likelihood of opioid prescriptions before the pandemic, became non-significant during the pandemic.

conclusionOur study demonstrated that emergency clinicians increased the prescribed amount of opioids per prescription during the COVID-19 pandemic compared to the pre-pandemic period. Etiologies for this finding could include lack of access to primary care and other specialties during the pandemic, or lower volumes allowing for emergency clinicians to identify who is safe to be prescribed opioids.

Indexed as

Analgesics, OpioidCOVID-19AdultEmergency Service, HospitalHumansPandemicsPractice Patterns, Physicians'Analgesics, OpioidCOVID-19 pandemicInterrupted time seriesOpioid prescriptions

Identifiers

PMID35367681
PMCPMC8956353
OpenAlexW4220715034

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.