Evidence map›Paper›PMID 38497237›Full record

ArticleAge and ageing2024

Short- and long-term safety of discontinuing chronic opioid therapy among older adults with Alzheimer's disease and related dementia.

Yu-Jung Jenny Wei, Almut G Winterstein, Siegfried Schmidt, Roger B Fillingim, Stephan Schmidt, Michael J Daniels, Steven T DeKosky

Open access · bronzeAbstract read
In one paragraph

Article in Age and ageing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 34% 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 citations in OpenAlex.

  1. 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

7 authors at 3 institutions in 1 country.

Yu-Jung Jenny WeiDivision of Outcomes and Translational Sciences, College of Pharmacy, The Ohio State University, Columbus, OH 43210, USA.ORCID 0000-0001-8861-6907
Almut G WintersteinDepartment of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA.
Siegfried SchmidtDepartment of Community Health and Family Medicine, College of Medicine, University of Florida, Gainesville, FL 32610, USA.
Roger B FillingimPain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA.
Stephan SchmidtDepartment of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA.
Michael J DanielsDepartment of Statistics, College of Liberal Arts and Sciences, University of Florida, Gainesville FL, 32610, USA.
Steven T DeKoskyDepartment of Neurology, McKnight Brain Institute, University of Florida, Gainesville, FL 32610, USA.
University of Florida · USCenter for Drug Evaluation and Research · USThe Ohio State University · US

Funding

Opioid Prescribing Practices and Health Outcomes among Patients with Alzheimer's Disease and Related DementiaR01AG073442 · NIA · OHIO STATE UNIVERSITY · PI WEI, YU-JUNG “JENNY” · 2022 to 2025
$2.2M
NIA NIH HHS R01 AG073442NIA NIH HHS R01AG073442
6 · The paper itself

Abstract

backgroundLimited evidence exists on the short- and long-term safety of discontinuing versus continuing chronic opioid therapy (COT) among patients with Alzheimer's disease and related dementias (ADRD).

methodsThis cohort study was conducted among 162,677 older residents with ADRD and receipt of COT using a 100% Medicare nursing home sample. Discontinuation of COT was defined as no opioid refills for ≥90 days. Primary outcomes were rates of pain-related hospitalisation, pain-related emergency department visit, injury, opioid use disorder (OUD) and opioid overdose (OD) measured by diagnosis codes at quarterly intervals during 1- and 2-year follow-ups. Poisson regression models were fit using generalised estimating equations with inverse probability of treatment weights to model quarterly outcome rates between residents who discontinued versus continued COT.

resultsThe study sample consisted of 218,040 resident episodes with COT; of these episodes, 180,916 residents (83%) continued COT, whereas 37,124 residents (17%) subsequently discontinued COT. Discontinuing (vs. continuing) COT was associated with higher rates of all outcomes in the first quarter, but these associations attenuated over time. The adjusted rates of injury, OUD and OD were 0, 69 and 60% lower at the 1-year follow-up and 11, 81 and 79% lower at the 2-year follow-up, respectively, for residents who discontinued versus continued COT, with no difference in the adjusted rates of pain-related hospitalisations or emergency department visits.

conclusionsThe rates of adverse outcomes were higher in the first quarter but lower or non-differential at 1-year and 2-year follow-ups between COT discontinuers versus continuers among older residents with ADRD.

Indexed as

Alzheimer DiseaseOpioid-Related DisordersAgedAnalgesics, OpioidCohort StudiesHumansMedicarePainRetrospective StudiesUnited StatesAnalgesics, OpioidAlzheimer’s disease and related dementialong-term opioid therapynursing homeolder peopleopioid-related adverse events

Identifiers

PMID38497237
PMCPMC10945292
OpenAlexW4392918574

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Registered trials

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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.