ArticlemedRxiv : the preprint server for health sciences2025
Effectiveness of slow-release oral morphine versus other OAT regimens in key sub-populations: protocol for population-based target trial emulation.
Article in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
Introduction: Slow-release oral morphine (SROM) was introduced as an alternative form of opioid agonist treatment (OAT) in British Columbia (BC), Canada in 2017. While clinical guidelines in BC recommend SROM based on expert consensus and experience, there is limited real-world evidence on populations most likely to benefit from SROM compared to other forms of OAT, particularly in the context of widespread fentanyl exposure. We will estimate the comparative effectiveness of SROM versus methadone and buprenorphine/naloxone on OAT discontinuation and all-cause mortality among key sub-populations in BC. Methods: We will conduct a population-level retrospective cohort study using linked data from nine provincial health administrative databases. The study population includes adults (≥18 years) in BC who initiated SROM, methadone, or buprenorphine/naloxone between June 1, 2017, and December 31, 2022. Key sub-populations will include incident users with no prior OAT history and prevalent new users with prior OAT experience stratified by OAT type, stability, and medication switching history. The primary outcomes are time to OAT discontinuation and all-cause mortality, while overdose-related acute care visits will be examined as a secondary outcome. To estimate both the initiator effect and the effect of treatment at guideline-recommended doses, we will apply marginal structural models using inverse probability treatment weighting and 'clone-censor-weights' approach to address confounding by indication and time-varying confounding. Sensitivity analyses will evaluate the robustness of our findings, including cohort and timeline restrictions, alternative outcome definitions, and alternative estimation strategies including high-dimensional propensity score and instrumental variable approaches. Discussion: This study will generate real-world evidence on the comparative effectiveness of SROM versus methadone and buprenorphine/naloxone across clinically distinct OAT sub-populations. The findings will support evidence-informed updates to OAT guidelines and clinical decision-making in BC and other jurisdictions facing escalating opioid-related harms.
Identifiers
What OpenQuestion holds
Registered trials
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.