Evidence map›Paper›PMID 36948493›Full record

ArticleThe journal of allergy and clinical immunology. In practice2023

Association of Reported Nonsteroidal Anti-Inflammatory Drug (NSAID) Adverse Drug Reactions With Opioid Prescribing After Total Joint Arthroplasty.

Lily Li, Yuchiao Chang, Elena Losina, Karen H Costenbader, Antonia F Chen, Tanya M Laidlaw

Open access · greenAbstract read
In one paragraph

Article in The journal of allergy and clinical immunology. In practice, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.4field-weighted citation impact, top 19% 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

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. How to Define and Manage Low-Risk Drug Allergy Labels.The journal of allergy and clinical immunology. In practice · 2024
    Review
  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 at 2 institutions in 1 country.

Lily LiDivision of Allergy and Clinical Immunology, Department of Medicine, Brigham and Women's Hospital, Boston, Mass; Department of Medicine, Harvard Medical School, Boston, Mass. Electronic address: lilyli@bwh.harvard.edu.
Yuchiao ChangDepartment of Medicine, Harvard Medical School, Boston, Mass; Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Mass.
Elena LosinaDepartment of Orthopedic Surgery, Brigham and Women's Hospital, Boston, Mass; Department of Orthopedic Surgery, Harvard Medical School, Boston, Mass.
Karen H CostenbaderDepartment of Medicine, Harvard Medical School, Boston, Mass; Division of Rheumatology, Inflammation, and Immunity, Department of Medicine, Brigham and Women's Hospital, Boston, Mass.
Antonia F ChenDepartment of Orthopedic Surgery, Brigham and Women's Hospital, Boston, Mass; Department of Orthopedic Surgery, Harvard Medical School, Boston, Mass.
Tanya M LaidlawDivision of Allergy and Clinical Immunology, Department of Medicine, Brigham and Women's Hospital, Boston, Mass; Department of Medicine, Harvard Medical School, Boston, Mass.
Brigham and Women's Hospital · USHarvard University · US

Funding

Therapeutic Control of Aspirin-Exacerbated Respiratory DiseaseU19AI095219 · NIAID · BRIGHAM AND WOMEN'S HOSPITAL · PI Maria Gutierrez-Arcelus · 2011 to 2026
$29.1M
IMMUNOLOGIC BASIS OF RESISTANCE AND HYPERSENSITIVITYT32AI007306 · NIAID · BRIGHAM AND WOMEN'S HOSPITAL · PI Nora Amanda Barrett, Joshua A Boyce · 1985 to 2026
$12.2M
VERITY: Value and Evidence in Rheumatology using bioInformaTics, and advanced analYticsP30AR072577 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI Katherine Phoenix Liao · 2017 to 2026
$9.8M
Optimizing the value of pain management in knee OA patients with comorbiditiesR01AR074290 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI Elena Losina · 2018 to 2026
$5.9M
Patient Oriented Research and Mentoring Program in OrthopedicsK24AR057827 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI LOSINA, ELENA · 2010 to 2019
$1.7M
Cardiovascular Disease Epidemiology in Patients with LupusK24AR066109 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI COSTENBADER, KAREN H · 2014 to 2023
$1.7M
Clinical Impact and Epidemiology of Nonsteroidal Anti-inflammatory Drug AllergiesK23AI163371 · NIAID · UNIVERSITY OF WASHINGTON · PI LI, LILY · 2021 to 2025
$921k
NIAID NIH HHS K23 AI163371NIAID NIH HHS T32 AI007306NIAID NIH HHS U19 AI095219NIAMS NIH HHS K24 AR057827NIAMS NIH HHS K24 AR066109NIAMS NIH HHS P30 AR072577NIAMS NIH HHS R01 AR074290
6 · The paper itself

Abstract

backgroundNonsteroidal anti-inflammatory drugs (NSAIDs) are indicated for postoperative pain management, but use may be precluded by the report of adverse drug reactions (ADRs). The effect of NSAID ADR labeling on opioid prescribing after total joint arthroplasty (TJA) is unknown.

objectiveTo assess the association between NSAID ADRs and postoperative opioid prescribing after TJA, a common surgical procedure.

methodsWe performed a retrospective cohort study of adults who underwent total joint (knee or hip) replacement in a single hospital network between April, 1, 2016, and December 31, 2019. Demographic information, clinical and surgical characteristics, and prescription data were obtained from the electronic health record. We studied the association between reported NSAID ADRs and postoperative opioid prescribing in a propensity score-matched sample over 1 year of follow-up.

resultsNSAID ADRs were reported by 9.6% of the entire cohort (n = 584/6091). NSAID ADR was associated with 41% higher odds of receipt of opioid prescriptions at 181 to 365 days after hospital discharge (95% confidence interval: 13%-75%) in a propensity score-matched sample. Over 98% of individuals received an opioid prescription at the time of hospital discharge, with no difference in overall median opioid dose prescribed by NSAID ADR status. However, more patients with NSAID ADRs (7.6% vs 4.7%) received cumulative opioid doses ≥ 750 morphine milligram equivalents (MME) at discharge (P = .004).

conclusionReported NSAID ADR was associated with increased risk for prolonged receipt of opioids at 181 to 365 days postoperatively. Patients with NSAID ADRs more frequently received cumulative opioid doses ≥ 750 MME at discharge after TJA. Clarification and evaluation of reported NSAID ADRs may be particularly beneficial for surgical patients at high risk for prolonged receipt of opioids.

Indexed as

Analgesics, OpioidDrug-Related Side Effects and Adverse ReactionsAdultAnti-Inflammatory Agents, Non-SteroidalArthroplastyEndrinHumansPostoperative PainPractice Patterns, Physicians'Retrospective StudiesAnalgesics, OpioidAnti-Inflammatory Agents, Non-SteroidalEndrinMMEAdverse drug reactionAnalgesicsAspirinDrug allergyElectronic health recordHypersensitivityNonsteroidal anti-inflammatory drug (NSAID)Opioid use disorderOrthopedic surgeryTotal joint arthroplastyUtilization

Identifiers

PMID36948493
PMCPMC10272084
OpenAlexW4328107215

What OpenQuestion holds

Textmetadata
LicenceTDM
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.