Evidence map›Paper›PMID 42175436›Full record

ArticleMedicine2026

Polypharmacy, pain-related disability, and treatment fragmentation among U.S. adults without clinician advice to limit alcohol or tobacco use: A cross-sectional analysis of the 2022 Medical Expenditure Panel Survey.

Fares Qeadan, William A Barbeau, Philip J Kroth

Abstract read
In one paragraph

Article in Medicine, 2026. 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

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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.

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

3 authors.

Fares QeadanParkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL.ORCID 0000-0002-3376-220
William A BarbeauParkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL.
Philip J KrothDepartment of Biomedical Informatics, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Pain-related disability often co-occurs with complex care patterns and high medication burden. Fragmented ambulatory care and polypharmacy may heighten adverse outcomes even among adults without clinician-identified alcohol or tobacco concerns. Using a cross-sectional analysis of the 2022 Medical Expenditure Panel Survey, we estimated the prevalence of ambulatory treatment fragmentation and polypharmacy among US adults with moderate-to-severe pain who had not received clinician advice to limit alcohol or tobacco use, and assessed their associations with emergency and inpatient utilization. The analytic sample included 1547 adults reporting moderate-to-severe pain interference with work. Treatment fragmentation was defined as seeing ≥5 unique provider specialties, and polypharmacy as filling ≥5 unique prescription medications in 2022. Outcomes were the number of emergency department (ED) visits and inpatient discharges. Survey-weighted ordinal logistic regression was used to estimate adjusted associations. High treatment fragmentation and polypharmacy occurred in 27.7% and 61.5% of adults with pain, respectively. The most common specialties were general practice (39.5%) and nursing (35.8%), and the most filled medications were atorvastatin (23.9%), metoprolol (15.5%), and gabapentin (15.4%). Each additional 5 specialties seen was associated with more ED visits (adjusted odds ratio [aOR] = 1.59; 95% confidence interval [CI], 1.15-2.21) but was not significantly associated with inpatient discharges (aOR = 1.38; 95% CI, 0.92-2.05). Each additional 5 unique medications filled was associated with more ED visits (aOR = 1.47; 95% CI, 1.24-1.74) and inpatient discharges (aOR = 1.44; 95% CI, 1.19-1.74). These findings suggest that care fragmentation and polypharmacy are common among adults with pain who have not received clinician advice to limit alcohol or tobacco use and are independently associated with greater acute-care utilization. Strengthening care coordination and medication oversight may help mitigate these risks.

Indexed as

Alcohol DrinkingPainPolypharmacyAdultAgedAmbulatory CareCross-Sectional StudiesEmergency Room VisitsEmergency Service, HospitalFemaleHealth ExpendituresHumansMaleMiddle AgedSurveys and QuestionnairesTobacco Usecare coordinationchronic painhealthcare utilizationpolypharmacytreatment fragmentation

Identifiers

PMID42175436
PMCPMC13201002

What OpenQuestion holds

Textmetadata
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.