National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Adverse Drug Events (ADE) (6)
- (-) Adverse Events (6)
- Behavioral Health (2)
- Chronic Conditions (2)
- Dental and Oral Health (1)
- Depression (1)
- Elderly (4)
- Falls (1)
- Hospital Discharge (1)
- Injuries and Wounds (1)
- Medication (6)
- Medication: Safety (2)
- (-) Opioids (6)
- Pain (3)
- Patient Safety (2)
- Practice Patterns (1)
- Risk (3)
- Substance Abuse (3)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 6 of 6 Research Studies DisplayedWei YJ, Chen C, Cheng TD
Association of injury after prescription opioid initiation with risk for opioid-related adverse events among older Medicare beneficiaries in the United States: a nested case-control study.
This study’s objectives were to examine the association between incident injury after prescription opioid initiation and subsequent risk of opioid-related adverse events (ORAEs) and to assess whether the association differs by recency of injury among older patients. The researchers observed that incident diagnosis of injury following opioid initiation was associated with subsequent increased risk of ORAEs, and the risk was only significant among patients with injury in the month before the index date. They recommended regular monitoring for injury in order to identify older opioid users at high risk for ORAEs.
AHRQ-funded; HS027230.
Citation: Wei YJ, Chen C, Cheng TD .
Association of injury after prescription opioid initiation with risk for opioid-related adverse events among older Medicare beneficiaries in the United States: a nested case-control study.
PLoS Med 2022 Sep;19(9):e1004101. doi: 10.1371/journal.pmed.1004101..
Keywords: Opioids, Medication, Adverse Drug Events (ADE), Substance Abuse, Elderly, Adverse Events
Khouja T, Zhou J, Gellad WF
Serious opioid-related adverse outcomes associated with opioids prescribed by dentists.
This study’s objective was to evaluate adverse outcomes and persistent opioid use (POU) after opioid prescriptions by dentists, based on whether opioids were overprescribed or within recommendations. A cross-sectional analysis of adults with dental visit and corresponding opioid prescription from 2011 to 2017 within a nationwide commercial claims database was conducted. As per CDC guidelines, opioid overprescribing was defined as >120 morphine milligram equivalents. Of 633,387 visits, 16.6% had POU and 2.6% experienced an adverse outcome. POU was higher when opioids were overprescribed with visits associated with mild pain and those with substance use disorders having the highest risk of both outcomes.
AHRQ-funded; HS025177.
Citation: Khouja T, Zhou J, Gellad WF .
Serious opioid-related adverse outcomes associated with opioids prescribed by dentists.
Pain 2022 Aug 1;163(8):1571-80. doi: 10.1097/j.pain.0000000000002545..
Keywords: Opioids, Dental and Oral Health, Substance Abuse, Behavioral Health, Practice Patterns, Pain, Medication, Adverse Drug Events (ADE), Adverse Events
Chen C, Winterstein AG, Lo-Ciganic WH
Concurrent use of prescription gabapentinoids with opioids and risk for fall-related injury among older US Medicare beneficiaries with chronic noncancer pain: a population-based cohort study.
This study compared the risk of fall-related injury in two cohorts who used gabapentinoids concurrently with opioid use and those who used opioids only. The authors created 2 cohorts based on whether concurrent users initiated gabapentinoids on the day of opioid initiation (Cohort 1) or after opioid initiation (Cohort 2). Both cohorts were identified from a sample of older Medicare beneficiaries with chronic non-cancer pain (CNCP). Four concurrent users were matched up with 1 opioid-only user. They identified 6,733 concurrent users and 27,092 matched opioid-only users in Cohort 1 and 5,709 concurrent users and 22,388 matched opioid-only users in Cohort 2. Cohort 1’s incidence rate of fall-related injury was 24.5 per 100 person-users during follow-up and was 18.0 per 100-person-years during follow-up for Cohort 2. Concurrent users had had similar risk of fall-related injury as opioid-only users in Cohort 1 but had higher risk for fall-related injury than opioid-only users in Cohort 2.
AHRQ-funded; HS027230.
Citation: Chen C, Winterstein AG, Lo-Ciganic WH .
Concurrent use of prescription gabapentinoids with opioids and risk for fall-related injury among older US Medicare beneficiaries with chronic noncancer pain: a population-based cohort study.
PLoS Med 2022 Mar;19(3):e1003921. doi: 10.1371/journal.pmed.1003921..
Keywords: Elderly, Opioids, Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Falls, Patient Safety, Injuries and Wounds, Pain, Chronic Conditions
Wei YJ, Chen C, Lewis MO
Trajectories of prescription opioid dose and risk of opioid-related adverse events among older Medicare beneficiaries in the United States: a nested case-control study.
This study used a sample of older patients who are Medicare beneficiaries who were newly prescribed opioids to determine rates of 4 prescription opioid dose trajectories and the risk of opioid-related adverse events (ORAEs). A 5% random sample of Medicare beneficiaries from 2011 to 2018 was used to conduct a nested case-control study of patients age 65 and older who were newly diagnosed with chronic noncancer pain (CNCP). Among the cases and controls, 2,192 (70.6%) were women and mean age was 77.1 years. Four prescribed opioid trajectories before the incident ORAE diagnosis or matched date emerged: gradual dose discontinuation (from ≤3 to 0 daily morphine milligram equivalent (MME), 1,456 [23.5%]), gradual dose increase (from 0 to >3 daily MME, 1,878 [30.3%]), consistent low dose (between 3 and 5 daily MME, 1,510 [24.3%]), and consistent moderate dose (>20 daily MME, 1,362 [22.0%]). Less than 5% were prescribed a mean daily dose of ≥90 daily MME during 6 months before diagnosis or matched date. Patients with gradual dose discontinuation versus those with a consistent low or moderate dose, and increase dose were more likely to be 65 to 74 years, Midwest US residents, and receiving no low-income subsidy. Those with gradual dose increase and consistent moderate dose had a higher risk of ORAE, after adjustment for covariates.
AHRQ-funded; HS027230.
Citation: Wei YJ, Chen C, Lewis MO .
Trajectories of prescription opioid dose and risk of opioid-related adverse events among older Medicare beneficiaries in the United States: a nested case-control study.
PLoS Med 2022 Mar;19(3):e1003947. doi: 10.1371/journal.pmed.1003947..
Keywords: Elderly, Opioids, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Chronic Conditions, Pain, Substance Abuse, Behavioral Health, Medication: Safety, Patient Safety
Yunusa I, Gagne JJ, Yoshida K
Risk of opioid overdose associated with concomitant use of oxycodone and selective serotonin reuptake inhibitors.
Oxycodone is a potent prescription opioid. Some Selective Serotonin Reuptake Inhibitors (SSRIs) inhibit oxycodone metabolism in the body, but the clinical consequences of this interaction on overdose risk have not been adequately determined. The study researchers compared the rates of opioid overdoses in patients who had initiated oxycodone while taking enzyme-inhibiting SSRIs with the overdose rates of patents who had initiated oxycodone while taking non-enzyme inhibiting SSRIs. Data from 3 U.S. health insurance databases was used to analyze a cohort of adults who initiated oxycodone while receiving SSRI therapy between the years 2000 and 2020. Of the total of 2,037,490 who initiated oxycodone, 69.6% were receiving SSRIs at the time of the initiation of the oxycodone. One-thousand-thirty-five overdose events were observed during this time, and the resulting incidence rate in those initiating oxycodone while using enzyme-inhibiting SSRI’s was higher than in those using other SSRIs. The researchers concluded that in the study cohort of U.S. adults, there is a small increased risk of opioid overdose when initiating oxycodone in patients taking enzyme-inhibiting SSRIs.
AHRQ-funded; HS027623.
Citation: Yunusa I, Gagne JJ, Yoshida K .
Risk of opioid overdose associated with concomitant use of oxycodone and selective serotonin reuptake inhibitors.
JAMA Netw Open 2022 Feb;5(2):e220194. doi: 10.1001/jamanetworkopen.2022.0194..
Keywords: Opioids, Medication, Risk, Depression, Adverse Drug Events (ADE), Adverse Events
Herzig SJ, Anderson TS,, Jung y
Risk factors for opioid-related adverse drug events among older adults after hospital discharge.
This study examined patient- and prescribing-related risk factors for opioid-related adverse drug events (ADEs) after hospital discharge among medical patients. Administrative billing codes and medication claims were used to define potential opioid-related ADEs within 30 days of hospital discharge. Findings showed that potential opioid-related ADEs occurred in 7% of older adults discharged from a medical hospitalization with an opioid prescription. Recommendations included using identified risk factors to inform physician decision-making, having conversations with older adults about risk, and increasing development and targeting of harm reduction strategies.
AHRQ-funded; HS026215.
Citation: Herzig SJ, Anderson TS,, Jung y .
Risk factors for opioid-related adverse drug events among older adults after hospital discharge.
J Am Geriatr Soc 2022 Jan;70(1):228-34. doi: 10.1111/jgs.17453..
Keywords: Elderly, Opioids, Risk, Adverse Drug Events (ADE), Adverse Events, Medication, Hospital Discharge