Evidence map›Paper›PMID 38191211›Full record

ArticlePain medicine (Malden, Mass.)2024

Trajectories of prescription opioid tapering in patients with chronic non-cancer pain: a retrospective cohort study, 2015-2020.

Monica Jung, Ting Xia, Jenni Ilomäki, Christopher Pearce, Suzanne Nielsen

Abstract read
In one paragraph

Article in Pain medicine (Malden, Mass.), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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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

5 authors.

Monica JungMonash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC 3199, Australia.ORCID 0000-0001-6458-1279
Ting XiaMonash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC 3199, Australia.
Jenni IlomäkiCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, VIC 3052, Australia.ORCID 0000-0002-0348-9441
Christopher PearceMelbourne East General Practice Network (trading as Outcome Health), Surrey Hills, VIC 3127, Australia.
Suzanne NielsenMonash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC 3199, Australia.

Funding

AstraZenicaAustralian National Health and Medical Research Council #2002193Monash Addiction Research Centre
6 · The paper itself

Abstract

objectiveTo identify common opioid tapering trajectories among patients commencing opioid taper from long-term opioid therapy for chronic non-cancer pain and to examine patient-level characteristics associated with these different trajectories.

designA retrospective cohort study.

settingAustralian primary care. SUBJECTS: Patients prescribed opioid analgesics between 2015 and 2020.

methodsGroup-based trajectory modeling and multinomial logistic regression analysis were conducted to determine tapering trajectories and to examine demographic and clinical factors associated with the different trajectories.

resultsA total of 3369 patients commenced a taper from long-term opioid therapy. Six distinct opioid tapering trajectories were identified: low dose / completed taper (12.9%), medium dose / faster taper (12.2%), medium dose / gradual taper (6.5%), low dose / noncompleted taper (21.3%), medium dose / noncompleted taper (30.4%), and high dose / noncompleted taper (16.7%). A completed tapering trajectory from a high opioid dose was not identified. Among patients prescribed medium opioid doses, those who completed their taper were more likely to have higher geographically derived socioeconomic status (relative risk ratio [RRR], 1.067; 95% confidence interval [CI], 1.001-1.137) and less likely to have sleep disorders (RRR, 0.661; 95% CI, 0.463-0.945) than were those who didn't complete their taper. Patients who didn't complete their taper were more likely to be prescribed strong opioids (eg, morphine, oxycodone), regardless of whether they were tapered from low (RRR, 1.444; 95% CI, 1.138-1.831) or high (RRR, 1.344; 95% CI, 1.027-1.760) doses.

conclusionsThose prescribed strong opioids and high doses appear to be less likely to complete tapering. Further studies are needed to evaluate the clinical outcomes associated with the identified trajectories.

Indexed as

Analgesics, OpioidChronic PainAustraliaHumansPrescriptionsRetrospective StudiesAnalgesics, Opioidchronic non-cancer paingeneral practicegroup-based trajectory modelslong-term opioid therapyopioidsopioid taper

Identifiers

PMID38191211
PMCPMC10988287

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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.