Evidence map›Paper›PMID 40202758›Full record

ArticleJAMA network open2025

Opioid Cap Laws and Opioid Prescriptions After Total Joint Replacements in Older Adults.

Caroline P Thirukumaran, Derek T Schloemann, Jalpa A Doshi, Kevin A Fiscella, Benjamin F Ricciardi, Meredith B Rosenthal

Abstract read
In one paragraph

Article in JAMA network open, 2025. 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
–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

1 citing paper in PubMed.

  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

6 authors.

Caroline P ThirukumaranDepartment of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Derek T SchloemannDepartment of Orthopaedics and Physical Performance, University of Rochester, Rochester, New York.
Jalpa A DoshiDivision of General Internal Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia.
Kevin A FiscellaDepartment of Family Medicine, University of Rochester, Rochester, New York.
Benjamin F RicciardiDepartment of Orthopaedics and Physical Performance, University of Rochester, Rochester, New York.
Meredith B RosenthalDepartment of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.

Funding

Racial Disparities in Analgesic Prescribing for Post-Surgical Pain Management among Older Americans following Hip and Knee Replacement SurgeriesR21AG078552 · NIA · UNIVERSITY OF ROCHESTER · PI THIRUKUMARAN, CAROLINE PINTO · 2022 to 2023
$400k
NIA NIH HHS R21 AG078552
6 · The paper itself

Abstract

Importance: Despite the opioid crisis and a growing call for minimizing opioid use, opioids remain an important part of postoperative pain management, with more than 80% of patients filling at least 1 opioid prescription following total joint replacements (TJRs). Little is known as to whether state laws that restrict or cap opioids for acute pain reduce post-TJR opioid use. Objective: To evaluate the association of an opioid cap law in New York (Section 3331) with post-TJR opioid prescribing. Design, Setting, and Participants: This cohort study analyzed Medicare data from 2014 to 2019 for New York and California (control state). Participants were Medicare beneficiaries who underwent elective TJRs before (April 2014 to June 2016) or after (August 2016 to September 2019) Section 3331 implementation. Data were analyzed from June 2023 to August 2024. Exposure: Implementation of New York Section 3331 in July 2016. Main Outcomes and Measures: The primary end point was total morphine milligram equivalents (MMEs) filled from discharge to day 7, days 8 to 30, and days 31 to 90 after TJR. Key independent variables were legislation phase (before or after Section 3331 implementation), treatment or control state, and the interactions between these 2 variables. Difference-in-differences regression models were used to assess the association of interest. Results: The pre-Section 3331 cohort included 32 253 TJR encounters among 31 028 patients, of whom 9924 (31.98%) underwent TJRs in New York hospitals. The mean (SD) age of the cohort was 73.43 (5.49) years; 19 442 encounters (60.28%) were among females. The estimated change in total MMEs filled in the 7-day post-TJR period after vs before Section 3331 implementation was -135.08 (95% CI, -146.62 to -123.53; P < .001) in California and -178.00 (95% CI, -191.98 to -164.02; P < .001) in New York, resulting in a Section 3331-associated change of -42.92 MMEs (95% CI, -61.04 to -24.80 MMEs; P < .001) in New York compared with California. Section 3331 was not associated with statistically significant changes in total MMEs filled in the 8 to 30-day and 31 to 90-day post-TJR periods. Conclusions and Relevance: The findings of this retrospective cohort study of TJRs among Medicare beneficiaries suggest that New York Section 3331 achieved its intended objective, as it was associated with reduced opioid fills in the immediate 7-day post-TJR period in New York compared with California. Additional refinements may further reduce opioid prescribing in New York, and these findings may serve as a foundation for refining laws in other states that may not achieve their intended targets or have not implemented similar laws.

Indexed as

Analgesics, OpioidArthroplasty, ReplacementDrug and Narcotic ControlDrug PrescriptionsPostoperative PainPractice Patterns, Physicians'AgedAged, 80 and overCaliforniaCohort StudiesFemaleHumansMaleMedicareNew YorkUnited StatesAnalgesics, Opioid

Identifiers

PMID40202758
PMCPMC11983234

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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.