Evidence map›Paper›PMID 39625757›Full record

Observational studyThe western journal of emergency medicine2024

Opioid Treatment Is Associated with Recurrent Healthcare Visits, Increased Side Effects, and Pain.

Caroline E Freiermuth, Jenny A Foster, Pratik Manandhar, Evangeline Arulraja, Alaattin Erkanli, Charles V Pollack, Stephanie A Eucker

Abstract readObservational Study
In one paragraph

Observational study in The western journal of emergency medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. 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.

Caroline E FreiermuthUniversity of Cincinnati, Department of Emergency Medicine, Cincinnati, Ohio.
Jenny A FosterDuke University School of Medicine, Durham, North Carolina.
Pratik ManandharDuke University, Department of Biostatistics and Bioinformatics, Durham, North Carolina.
Evangeline ArulrajaDuke University, Department of Emergency Medicine, Durham, North Carolina.
Alaattin ErkanliDuke University, Department of Biostatistics and Bioinformatics, Durham, North Carolina.
Charles V PollackUniversity of Mississippi Medical Center, Department of Emergency Medicine, Jackson, Mississippi.
Stephanie A EuckerDuke University, Department of Emergency Medicine, Durham, North Carolina.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Pain is a major driver of visits to the emergency department (ED). Clinicians must consider not only the efficacy of treatment options but also subsequent healthcare utilization and patient-centered outcomes such as side effects from prescribed medications. Our goal in this study was to determine whether there was an association between acute pain treatment regimen (opioids, intranasal non-steroidal anti-inflammatory drugs [NSAIDs], or both) and unscheduled healthcare visits following ED discharge. Methods: This study was a secondary analysis of the Acute Management of Pain from the Emergency Department (AMPED) prospective, observational cohort study. We used Cox proportional hazards analysis to assess the relationship between treatment regimen and time to first unscheduled healthcare visit. Repeated measures logistic regression analyses were used to determine the relationship between treatment regimen and any unscheduled visits, and to evaluate whether this relationship was mediated by pain severity and/or medication side effects. Results: Of 831 total enrolled participants, 141 (16.9%) experienced an unplanned healthcare visit within five days of ED discharge. A majority of these visits happened one day after the ED visit. Those who were treated with intranasal NSAIDs only were less likely to have an unscheduled healthcare visit compared to those who received opioids only, with an adjusted odds ratio (AOR) of 0.63. The higher odds of unscheduled healthcare visits with opioids were mediated by both the presence of side effects and higher pain levels, with AORs of 2.24 and 1.33, respectively. Conclusion: Opioid treatment for acute pain is associated with increased unscheduled healthcare visits compared to those treated with intranasal ketorolac. This difference can be explained by higher levels of ongoing pain and greater medication side effects.

Indexed as

Analgesics, OpioidAnti-Inflammatory Agents, Non-SteroidalEmergency Service, HospitalAdministration, IntranasalAdultAgedFemaleHumansMaleMiddle AgedPain ManagementPain MeasurementProspective StudiesAnalgesics, OpioidAnti-Inflammatory Agents, Non-Steroidal

Identifiers

PMID39625757
PMCPMC11610737

What OpenQuestion holds

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LicenceCC BY
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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.