Evidence map›Paper›PMID 40921304›Full record

Observational studyAmerican journal of preventive medicine2025

Risks for Adverse Events by Sex and Age After Prescription Opioid Dose Reduction: A Secondary Analysis Across 8 U.S. Health Systems.

Verena E Metz, Vanessa A Palzes, Ingrid A Binswanger, Andrea Altschuler, Melissa N Poulsen, Brian K Ahmedani, Susan E Andrade, Robin E Clark, Rulin C Hechter, Michael A Horberg and 5 more

Abstract readObservational Study
In one paragraph

Observational study in American journal of preventive medicine, 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

15 authors.

Verena E MetzKaiser Permanente Northern California, Division of Research, Center for Addiction and Mental Health Research, Pleasanton, California. Electronic address: verena.e.metz@kp.org.
Vanessa A PalzesKaiser Permanente Northern California, Division of Research, Center for Addiction and Mental Health Research, Pleasanton, California.
Ingrid A BinswangerInstitute for Health Research, Kaiser Permanente Colorado, Denver, Colorado; Colorado Permanente Medical Group, Denver, Colorado; Department of Health Systems Sciences, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California; Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado.
Andrea AltschulerKaiser Permanente Northern California, Division of Research, Center for Addiction and Mental Health Research, Pleasanton, California.
Melissa N PoulsenDepartment of Population Health Sciences, Geisinger, Danville, Pennsylvania.
Brian K AhmedaniCenter for Health Policy & Health Services Research, Henry Ford Health, Detroit, Michigan.
Susan E AndradeMeyers Primary Care Institute, University of Massachusetts Chan Medical School, Worcester, Massachusetts.
Robin E ClarkDepartment of Family Medicine and Community Health, University of Massachusetts Chan School of Medicine, Worcester, Massachusetts.
Rulin C HechterDepartment of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California.
Michael A HorbergMid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Washington, District of Columbia.
Katherine SanchezBaylor Scott & White Research Institute, Dallas, Texas, and School of Social Work, University of Texas at Arlington, Arlington, Texas.
Steffani R BaileyDepartment of Family Medicine, Oregon Health & Science University, Portland, Oregon.
Kari A StephensDepartment of Family Medicine, University of Washington, Seattle, Washington.
Andrea L RubinsteinDepartment of Pain Medicine, The Permanente Medical Group, Santa Rosa, California.
Cynthia I CampbellKaiser Permanente Northern California, Division of Research, Center for Addiction and Mental Health Research, Pleasanton, California.

Funding

Project-002UG1DA040314 · NIDA · KAISER FOUNDATION RESEARCH INSTITUTE · PI Ingrid A Binswanger, CYNTHIA I CAMPBELL · 2015 to 2026
$34.9M
Western States Node of the National Drug Abuse Treatment Clinical Trials Network (TMS for CUD) UG1DA015815 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Keith N. Humphreys, Philip Todd Korthuis · 2015 to 2026
$24.6M
Clinical Trials Network: Pacific Northwest Node (CTN-0082, -0131, -0139 and dissemination library)UG1DA013714 · NIDA · UNIVERSITY OF WASHINGTON · PI Mary Akiko Hatch, John M. Roll · 2015 to 2026
$19.8M
NIDA NIH HHS UG1 DA013714NIDA NIH HHS UG1 DA015815NIDA NIH HHS UG1 DA040314
6 · The paper itself

Abstract

introductionPrescription opioid dose reductions can raise the risk of adverse events for patients on long-term opioid therapy for noncancer pain. Evidence on whether risks differ by age or sex is needed to support tailored clinical decision-making.

methodsIn 2024, a secondary analysis of an observational cohort study was conducted across 8 U.S. healthcare systems analyzing electronic health records and claims data from a prescription opioid registry (excluding buprenorphine prescriptions) between January 1, 2012, and December 31, 2018, including adults with stable prescription opioid use and a subsequent ≥2-month dose reduction period (n=60,040), yielding 600,234 dose reduction periods as the analytic sample. Differences in the association between dose reduction level (1% to <15%, 15% to <30%, 30% to <100%, and 100% from baseline) and potential adverse events (emergency department visits, opioid overdose, all-cause mortality, and benzodiazepine prescription fills) in the month after dose reduction by sex and age group were examined by including interaction terms in logistic regression models.

resultsOf the 600,234 dose reduction periods, 346,733 were among women, with a mean age of 57.5 (SD=13.2) years for women and 56.7 (SD=12.1) years for men. Associations between dose reduction levels and potential adverse events did not differ significantly by sex, but differed by age for emergency department visits: patients aged 40-64 and ≥65 years with dose reductions of 30% to <100% had lower odds than those aged 19-39 years (adjusted ratio of OR=0.87, CI=0.80, 0.96; adjusted ratio of OR=0.82, CI=0.74, 0.91, respectively).

conclusionsPatients aged <40 years may benefit from closer monitoring in the month after dose reduction, given their higher odds of an emergency department visit.

Indexed as

Analgesics, OpioidAdolescentAdultAgedAge FactorsCohort StudiesEmergency Service, HospitalFemaleHumansMaleMiddle AgedSex FactorsUnited StatesYoung AdultAnalgesics, Opioid

Identifiers

PMID40921304
PMCPMC12721370

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.