Evidence map›Paper›PMID 37162022›Full record

ArticlePM & R : the journal of injury, function, and rehabilitation2024

Diagnostic profiles associated with long-term opioid therapy in active duty servicemembers.

Steven Dufour, Amanda Banaag, Andrew J Schoenfeld, Rachel Sayko Adams, Tracey Perez Koehlmoos, Joshua C Gray

Open access · bronzeAbstract read
In one paragraph

Article in PM & R : the journal of injury, function, and rehabilitation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 41% 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, 1 synthesis or guideline pooled it, 1 citations in OpenAlex.

  1. Pooled it
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 5 institutions in 1 country.

Steven DufourDepartment of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.ORCID 0000-0001-5370-1343
Amanda BanaagThe Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland, USA.
Andrew J SchoenfeldDepartment of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Rachel Sayko AdamsDepartment of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA.
Tracey Perez KoehlmoosCenter for Health Services Research, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
Joshua C GrayDepartment of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
Uniformed Services University of the Health Sciences · USBoston University · USBrigham and Women's Hospital · USHenry M. Jackson Foundation · USNaval Medical Center Portsmouth · US

Funding

Trajectories of non-pharmacologic and opioid health services for pain management in association with military readiness and health status outcomes: SUPIC renewalR01AT008404 · NCCIH · BRANDEIS UNIVERSITY · PI ADAMS, RACHEL SAYKO, LARSON, MARY JO · 2014 to 2023
$7.2M
Integrating signals of suicide risk from DoD and VHA data to improve upon suicide risk prevention strategies for combat VeteransR01MH120122 · NIMH · UNIVERSITY OF COLORADO DENVER · PI ADAMS, RACHEL SAYKO, BRENNER, LISA A · 2019 to 2022
$1.9M
NCCIH NIH HHS R01 AT008404NCCIH NIH HHS R01AT008404NIMH NIH HHS R01 MH120122NIMH NIH HHS R01MH120122
6 · The paper itself

Abstract

introductionOver-prescription of opioids has diminished in recent years; however, certain populations remain at high risk. There is a dearth of research evaluating prescription rates using specific multimorbidity patterns.

objectiveTo identify distinct clinical profiles associated with opioid prescription and evaluate their relative odds of receiving long-term opioid therapy.

designRetrospective analysis of the complete military electronic health record. We assessed demographics and 26 physiological, psychological, and pain conditions present during initial opioid prescription. Latent class analysis (LCA) identified unique clinical profiles using diagnostic data. Logistic regression measured the odds of these classes receiving long-term opioid therapy.

settingAll electronic health data under the TRICARE network.

participantsAll servicemembers on active duty during fiscal years 2016 through 2019 who filled at least one opioid prescription.

main outcome measuresNumber and qualitative characteristics of LCA classes; odds ratios (ORs) from logistic regression. We hypothesized that LCA classes characterized by high-risk contraindications would have significantly higher odds of long-term opioid therapy.

resultsA total of N = 714,446 active duty servicemembers were prescribed an opioid during the study window, with 12,940 (1.8%) receiving long-term opioid therapy. LCA identified five classes: Relatively Healthy (82%); Musculoskeletal Acute Pain and Substance Use Disorders (6%); High Pain, Low Mental Health Burden (9%); Low Pain, High Mental Health Burden (2%), and Multisystem Multimorbid (1%). Logistic regression found that, compared to the Relatively Healthy reference, the Multisystem Multimorbid class, characterized by multiple opioid contraindications, had the highest odds of receiving long-term opioid therapy (OR = 9.24; p < .001; 95% confidence interval [CI]: 8.56, 9.98).

conclusionAnalyses demonstrated that classes with greater multimorbidity at the time of prescription, particularly co-occurring psychiatric and pain disorders, had higher likelihood of long-term opioid therapy. Overall, this study helps identify patients most at risk for long-term opioid therapy and has implications for health care policy and patient care.

Indexed as

Acute PainMilitary PersonnelOpioid-Related DisordersAnalgesics, OpioidHumansRetrospective StudiesAnalgesics, Opioid

Identifiers

PMID37162022
PMCPMC10786620
OpenAlexW4376121279

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.