Evidence map›Paper›PMID 37734725›Full record

ArticlePharmacoepidemiology and drug safety2024

Opioid tapering and mental health crisis in older adults.

Shishir Maharjan, Sujith Ramachandran, Kaustuv Bhattacharya, John P Bentley, Ike Eriator, Yi Yang

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

Article in Pharmacoepidemiology and drug safety, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.9field-weighted citation impact, top 9% 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

7 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Development of the barriers to opioid access scale among individuals with chronic pain.Exploratory research in clinical and social pharmacy · 2025
    Article
  6. The effects of a provincial opioid prescribing standard on prescribing for pain in adults: an interrupted time-series analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025
    Article
  7. 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.

Shishir MaharjanDepartment of Pharmacy Administration, University of Mississippi School of Pharmacy, University, Mississippi, USA.
Sujith RamachandranDepartment of Pharmacy Administration, University of Mississippi School of Pharmacy, University, Mississippi, USA.
Kaustuv BhattacharyaDepartment of Pharmacy Administration, University of Mississippi School of Pharmacy, University, Mississippi, USA.
John P BentleyDepartment of Pharmacy Administration, University of Mississippi School of Pharmacy, University, Mississippi, USA.
Ike EriatorDepartment of Anesthesiology, School of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA.
Yi YangDepartment of Pharmacy Administration, University of Mississippi School of Pharmacy, University, Mississippi, USA.
University of Mississippi · USUniversity of Mississippi Medical Center · US

Funding

Safety and Effectiveness of Opioid Tapering among Older AdultsR15DA046036 · NIDA · UNIVERSITY OF MISSISSIPPI · PI YANG, YI · 2018 to 2022
$875k
NIDA NIH HHS R15 DA046036
6 · The paper itself

Abstract

backgroundOpioid tapering and discontinuation have increased in recent years with the implementation of national prescribing guidelines. This study aimed to examine the relationship between opioid tapering velocity and mental health crisis events in older Medicare beneficiaries.

methodsA nested case-control study was conducted using the 2012-2018, 5% national Medicare claims data. Older adults with chronic non-cancer pain (CNCP) who were receiving long-term opioid therapy (LTOT) were included in the study. Cases were defined as individuals experiencing mental health crisis events; controls were identified using incidence density sampling. The opioid tapering velocity was measured in the 120-day hazard period that yielded a monthly percentage of dose change. Conditional logistic regression was used to assess the relationship of interest.

resultsA total of 42 091 older adults with CNCP were eligible for the study. Cases (n = 952) were matched with controls in a 1:2 ratio based on age (±1 year) and time of cohort entry (±30 days). A higher percentage of controls (67.65%) were on steady dose compared with cases (59.03%). In the adjusted model, tapering (aOR = 1.36; 95% CI: 1.02-1.83), rapid tapering (aOR = 1.45; 95% CI: 1.11-1.91), and dose escalation (aOR = 1.78; 95% CI: 1.32-2.39) were significantly associated with the mental health crisis, compared with steady dose.

conclusionBoth opioid tapering and dose escalation are associated with mental health crisis events. Patient-driven and gradual dose tapering, as recommended by prescribing guidelines, should be promoted to prevent mental health crisis events among older adults on LTOT.

Indexed as

Analgesics, OpioidChronic PainMental DisordersAgedCase-Control StudiesHumansMedicareUnited StatesAnalgesics, Opioidchronic non-cancer painlong-term opioid therapymental health crisisopioid escalationopioid tapering

Identifiers

PMID37734725
PMCPMC10841175
OpenAlexW4386914782

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.