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Search All Research Studies
Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (2)
- Behavioral Health (1)
- (-) Chronic Conditions (5)
- Elderly (3)
- Evidence-Based Practice (1)
- Falls (1)
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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 5 of 5 Research Studies DisplayedChen 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
Wyse J, Simmons A, Ramachandran B
"I don't mind doing what it takes to be safe." Patient perspectives of urine drug testing for pain.
This study sought to uncover patients’ beliefs regarding UDT and its implications for the patient–clinician relationship. Urine drug testing (UDT) is a standard recommendation for those prescribed long-term opioid therapy (LTOT) for pain but remains underutilized. Clinician fears regarding negative patient perceptions have been identified as a barrier to conducting UDT; however, little is known about patient perspectives of UDT.
AHRQ-funded; HS026370.
Citation: Wyse J, Simmons A, Ramachandran B .
"I don't mind doing what it takes to be safe." Patient perspectives of urine drug testing for pain.
J Gen Intern Med 2021 Jan;36(1):243-44. doi: 10.1007/s11606-020-05688-3..
Keywords: Pain, Chronic Conditions, Opioids, Medication, Medication: Safety, Patient Safety, Substance Abuse
Navis A, George MC, Nmashie A
Validation of the Safer Opioid Prescribing Evaluation Tool (SOPET) for assessing adherence to the Centers for Disease Control opioid prescribing guidelines.
This study assessed the use of the Safer Opioid Prescribing Evaluation Tool (SOPET) which was designed to improve the implementation of the 2016 Centers for Disease Control Guidelines on the prescription of opioids for chronic pain. Four raters with varying levels of clinical experience were trained to use the SOPET and then used it to evaluate 21 baseline patient scenarios. Inter-rater reliability was measured using intraclass correlation coefficient (ICC) estimates and their 95% confidence intervals for the total SOPET score based on a mean-rating absolute-agreement, two-way random-effects model. Inter-rater reliability was found to be good for the three physician raters (0.92, 0.97, and 0.99). However, inter-rater reliability for the non-physician rater was lower (0.67).
AHRQ-funded; HS025641.
Citation: Navis A, George MC, Nmashie A .
Validation of the Safer Opioid Prescribing Evaluation Tool (SOPET) for assessing adherence to the Centers for Disease Control opioid prescribing guidelines.
Pain Med 2020 Dec 25;21(12):3655-59. doi: 10.1093/pm/pnaa138..
Keywords: Opioids, Medication, Medication: Safety, Patient Safety, Guidelines, Practice Patterns, Pain, Chronic Conditions, Evidence-Based Practice
Naples JG, Gellad WF, Hanlon JT
The role of opioid analgesics in geriatric pain management.
This article reviews the epidemiology of opioid use and their effectiveness for chronic noncancer pain (CNCP) in older adults and summarizes important age-related changes in opioid pharmacokinetics and pharmacodynamics that increase the risks of adverse effects in the elderly. Finally, to assist clinicians with selecting appropriate therapy, the article concludes with an evidence-based approach to optimize opioid prescribing in older adults with CNCP.
AHRQ-funded; HS023779.
Citation: Naples JG, Gellad WF, Hanlon JT .
The role of opioid analgesics in geriatric pain management.
Clin Geriatr Med 2016 Nov;32(4):725-35. doi: 10.1016/j.cger.2016.06.006.
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Keywords: Chronic Conditions, Elderly, Medication, Opioids, Pain, Patient Safety