Evidence map›Paper›PMID 40997405›Full record

ArticleDrug and alcohol dependence2025

The association of opioid prescribing continuity and the risk of opioid use disorder among older adults.

Prachi Prajapati, Shadi Bazzazzadehgan, Yi Yang, Kaustuv Bhattacharya, Shishir Maharjan, John P Bentley, Sujith Ramachandran

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Drug and alcohol dependence, 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

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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

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5 · Who and what money

Authors and funding

7 authors.

Prachi PrajapatiDepartment of Pharmacy Administration, University of Mississippi, School of Pharmacy, University, MS 38677, United States.
Shadi BazzazzadehganDepartment of Pharmacy Administration, University of Mississippi, School of Pharmacy, University, MS 38677, United States.
Yi YangDepartment of Pharmacy Administration, University of Mississippi, School of Pharmacy, University, MS 38677, United States; Center for Pharmaceutical Marketing and Management, University of Mississippi School of Pharmacy, University, MS 38677, United States.
Kaustuv BhattacharyaDepartment of Pharmacy Administration, University of Mississippi, School of Pharmacy, University, MS 38677, United States; Center for Pharmaceutical Marketing and Management, University of Mississippi School of Pharmacy, University, MS 38677, United States.
Shishir MaharjanDepartment of Pharmacy Administration, University of Mississippi, School of Pharmacy, University, MS 38677, United States.
John P BentleyDepartment of Pharmacy Administration, University of Mississippi, School of Pharmacy, University, MS 38677, United States; Center for Pharmaceutical Marketing and Management, University of Mississippi School of Pharmacy, University, MS 38677, United States.
Sujith RamachandranDepartment of Pharmacy Administration, University of Mississippi, School of Pharmacy, University, MS 38677, United States; Center for Pharmaceutical Marketing and Management, University of Mississippi School of Pharmacy, University, MS 38677, United States. Electronic address: sramacha@olemiss.edu.

Funding

Safety and Effectiveness of Opioid Tapering among Older AdultsR15DA046036 · NIDA · UNIVERSITY OF MISSISSIPPI · PI YANG, YI · 2018 to 2022
$875k
NIDA NIH HHS R15 DA046036
6 · The paper itself

Abstract

backgroundLower opioid prescribing continuity is associated with a higher risk of opioid-related adverse events. This study aimed to evaluate the association between opioid prescribing continuity and risk of opioid use disorder (OUD).

methodsOlder adults (≥ 65 years) on long-term opioid therapy (LTOT) were identified from 2012 to 2020 5 % Medicare claims data. The study outcome was OUD. Opioid prescribing continuity, measured using the continuity of care index (COCI), was treated as a time-varying predictor measured monthly from LTOT initiation until outcome/censoring. The association between COCI and risk of OUD was evaluated using an extended Cox regression model.

resultsOf 153,570 patients, 7.61 % (n = 11,697) developed OUD after LTOT initiation. The mean (SD) age was 75.74 (8.42) years and 70.16 % (n = 107,743) were female. After adjusting for covariates, patients with medium COCI (adjusted hazard ratio [aHR] = 1.76, 95 % CI 1.58 - 1.96; p < .001) and high COCI (aHR = 1.32, 95 % CI 1.22 - 1.44; p < .001) had higher OUD risk compared to those with low COCI. Patients with high COCI (aHR = 0.75, 95 % CI 0.69 - 0.82; p < .001) had significantly lower hazard of OUD than those with medium COCI.

conclusionGreater opioid prescribing continuity may promote OUD detection, highlighting the importance of consistent care for better management of opioid-related conditions. Alternatively, highly fragmented care among patients with LTOT may lead to lower detection of OUD, despite patients potentially being at higher risk for OUD. Thus, it is important to build trustful patient-prescriber relationships for early OUD detection and management.

Indexed as

Long-term opioid therapyOpioid prescribing continuityOpioid use disorderPain management

Identifiers

PMID40997405
PMCPMC13374116

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LicenceCC BY-NC-ND
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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.