Evidence map›Paper›PMID 37269776›Full record

ArticleDrug and alcohol dependence2023

Prevalence of opioid and nonopioid pain management therapies among Medicare beneficiaries with musculoskeletal pain conditions from 2016 to 2019.

Patience Moyo, Jane Vaillant, Anthony Girard, Richa Gairola, Theresa I Shireman, Amal N Trivedi, Jessica S Merlin, Brandon D L Marshall

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

Article in Drug and alcohol dependence, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
4.6field-weighted citation impact, top 5% 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

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
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  6. Psychotropic Drug Use in Korean Patients With Osteoarthritis.Journal of Korean medical science · 2025
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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

8 authors at 2 institutions in 2 countries.

Patience MoyoBrown University School of Public Health, Department of Health Services, Policy, and Practice, Providence, RI, USA. Electronic address: patience_moyo@brown.edu.
Jane VaillantBrown University, Providence, RI, USA.
Anthony GirardBrown University School of Public Health, Department of Biostatistics, Providence, RI, USA.
Richa GairolaBrown University School of Public Health, Department of Epidemiology, Providence, RI, USA.
Theresa I ShiremanBrown University School of Public Health, Department of Health Services, Policy, and Practice, Providence, RI, USA.
Amal N TrivediBrown University School of Public Health, Department of Health Services, Policy, and Practice, Providence, RI, USA.
Jessica S MerlinCHAllenges in Managing and Preventing Pain (CHAMPP) Clinical Research Center, Division of General Internal Medicine, University of Pittsburgh, PA, USA.
Brandon D L MarshallBrown University School of Public Health, Department of Epidemiology, Providence, RI, USA.
Brown University · USUniversity of Pittsburgh · US

Funding

Chronic Pain Management and Outcomes in Adults With and Without Opioid Use DisorderR03DA051778 · NIDA · BROWN UNIVERSITY · PI DOW, PATIENCE MOYO · 2021 to 2022
$159k
NIDA NIH HHS R03 DA051778
6 · The paper itself

Abstract

introductionPain treatment guidelines prioritize nonopioid therapies over opioid medications to prevent opioid-related harms. We examined trends in receipt and intensity of nonpharmacologic, nonopioid medication, and opioid therapies among Medicare beneficiaries.

methodsUsing a 20% national random sample of Medicare data from 2016 to 2019, we identified fee-for-service beneficiaries with ≥2 diagnoses of back, neck, fibromyalgia, or osteoarthritis/joint pain annually. We excluded beneficiaries with cancer. We calculated annual proportions of beneficiaries who received physical therapy (PT), chiropractic care, gabapentin, and opioids, overall and in demographic, geographic, and clinical subgroups. We estimated the intensity of therapies using the annual number of visitsor prescription fills, prescription days' supply, and opioid dose.

resultsDuring 2016-2019, PT receipt increased (22.8% to 25.5%) and the mean number of visits among recipients of PT went from 12 to 13. Chiropractic receipt (~18%) and mean annual visits (~10) remained unchanged. The prevalence of gabapentin receipt was stable at ~22% and the mean annual number of fills was unchanged though gabapentin days increased slightly. Opioid prescribing decreased (56.7% to 46.5%) and reductions in opioid dose and duration were observed. Opioid receipt was high among beneficiaries who were under 65 years, American Indian/Alaska Native, Black/African American, or had opioid use disorder (OUD), in whom nonpharmacologic therapies were also received the least.

conclusionUtilization of nonopioid therapies lagged opioids among Medicare beneficiaries with musculoskeletal pain, with limited changes from 2016 to 2019. As opioid prescribing declines and alternative pain therapy receipt remains low, there are potential increasing risks of pain going untreated or undertreated and individuals seeking illicit opioids to alleviate their pain.

Indexed as

Analgesics, OpioidMusculoskeletal PainAgedGabapentinHumansMedicarePain ManagementPractice Patterns, Physicians'PrevalenceUnited StatesAnalgesics, OpioidGabapentinChiropractic careChronic painGabapentinMedicareOpioid prescribingPhysical therapy

Identifiers

PMID37269776
PMCPMC10330895
OpenAlexW4376879150

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.