Evidence map›Paper›PMID 35942598›Full record

ArticleThe Annals of pharmacotherapy2023

Co-prescribing of Central Nervous System-Active Medications for COPD Patients: Impact on Emergency Room Visits and Hospitalization.

Akhil Sood, Yong-Fang Kuo, Jordan Westra, Gulshan Sharma, Mukaila A Raji

Open access · greenAbstract read
In one paragraph

Article in The Annals of pharmacotherapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 31% 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

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. 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

5 authors at 1 institution in 1 country.

Akhil SoodDepartment of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.ORCID 0000-0001-6313-2738
Yong-Fang KuoDepartment of Preventive Medicine & Population Health, University of Texas Medical Branch, Galveston, TX, USA.
Jordan WestraDepartment of Preventive Medicine & Population Health, University of Texas Medical Branch, Galveston, TX, USA.
Gulshan SharmaDepartment of Pulmonary, Critical Care, & Sleep Medicine, University of Texas Medical Branch, Galveston, TX, USA.
Mukaila A RajiDepartment of Geriatric Medicine, University of Texas Medical Branch, Galveston, TX, USA.ORCID 0000-0002-7460-7281
The University of Texas Medical Branch at Galveston · US

Funding

UTMB OAIC Research Education Component (REC)P30AG024832 · NIA · UNIVERSITY OF TEXAS MEDICAL BR GALVESTON · PI JAMES S. GOODWIN, MD, MELISSA M. MORROW · 2005 to 2026
$26.7M
Pattern, Variation and Outcomes of Opioid Prescription in Older AdultsR01DA039192 · NIDA · UNIVERSITY OF TEXAS MED BR GALVESTON · PI KUO, YONG-FANG, RAJI, MUKAILA A · 2016 to 2023
$3.1M
NIA NIH HHS P30 AG024832NIDA NIH HHS R01 DA039192
6 · The paper itself

Abstract

backgroundAnxiety and chronic pain are common comorbidities in patients with chronic obstructive pulmonary disease (COPD), which are frequently managed with benzodiazepines (BZDs) and opioids, respectively.

objectiveThe purpose of this study was to determine whether different combinations of opioids, BZD, and their substitutes-gabapentinoids (GABA) and selective serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitors (SSRIs/SNRIs)-are associated with lower risk of acute respiratory events in COPD patients with co-occurring chronic pain and anxiety.

methodsThis retrospective cohort study used a nationally representative sample of Medicare beneficiaries with COPD, chronic pain, and anxiety. Patients were grouped based on drug combination (opioid + BZD/Z-hypnotics, opioid + GABA, opioid + SSRI/SNRI, BZD/Z-hypnotics + GABA, BZD/Z-hypnotics + SSRI/SNRI, GABA + SSRI/SNRI, or ≥3 drugs). The primary outcome was emergency room (ER) visit or hospitalization due to acute respiratory events assessed up to 180 days following initiation of drug combination. Overdose secondary to central nervous system (CNS)-related drugs was also assessed up to 180 days following initiation of drug combination.

resultsThe drug combination opioid + GABA was associated with decreased risk for ER visit (hazard ratio [HR] = 0.73; 95% CI = 0.61-0.87) and hospitalization (HR = 0.69; 95% CI = 0.55-0.85). Opioid + SSRI/SNRI also showed decreased risk for ER visit (HR = 0.84; 95% CI = 0.71-0.99). There was no significant difference in risk for CNS-related drug overdose among different drug combinations compared with opioid + BZD/Z-hypnotics. CONCLUSION AND RELEVANCE: Opioids in combination with GABA and SSRI/SNRI demonstrate relatively lower risk for acute respiratory events among patients with COPD and comorbid chronic pain and anxiety. The findings emphasize the need for multimodal management in this vulnerable population.

Indexed as

Chronic PainDrug OverdosePulmonary Disease, Chronic ObstructiveSerotonin and Noradrenaline Reuptake InhibitorsAgedAnalgesics, OpioidCentral Nervous SystemEmergency Service, Hospitalgamma-Aminobutyric AcidHospitalizationHumansHypnotics and SedativesMedicareRetrospective StudiesUnited StatesAnalgesics, Opioidgamma-Aminobutyric AcidHypnotics and SedativesSerotonin and Noradrenaline Reuptake InhibitorsbenzodiazepinesCOPDgabapentinoidsopioidsselective serotonin reuptake inhibitorsserotonin and norepinephrine reuptake inhibitors

Identifiers

PMID35942598
PMCPMC10508332
OpenAlexW4292452096

What OpenQuestion holds

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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.