SynthesisBMC medicine2020
Factors associated with the prescribing of high-dose opioids in primary care: a systematic review and meta-analysis.
Synthesis in BMC medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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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.
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Who cites it
13 citing papers in PubMed, 33 citations in OpenAlex.
- One in six admitted patients with low back pain received high daily opioid dosage in Australian hospitals: a cross-sectional study.BMC musculoskeletal disorders · 2026Article
- Private prescribing of controlled opioids in England, 2014-2021: a retrospective observational study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Observational
- Opioid Treatment in Primary Care: Knowledge and Practical Use of Opioid Therapy.Healthcare (Basel, Switzerland) · 2024Article
- Determining the Impact of Opioid Policy on Substance Use and Mental Health-Related Harms: Protocol for a Data Linkage Study.JMIR research protocols · 2023Article
- Long-term Safety, Dose Stability, and Efficacy of Opioids for Patients With Restless Legs Syndrome in the National RLS Opioid Registry.Neurology · 2023Article
- Article
- Averting a UK opioid crisis: getting the public health messages 'right'.Journal of the Royal Society of Medicine · 2022Article
- Healthcare resource utilisation and cost analysis associated with opioid analgesic use for non-cancer pain: A case-control, retrospective study between 2005 and 2015.British journal of pain · 2022Article
- Global, regional, and national consumption of controlled opioids: a cross-sectional study of 214 countries and non-metropolitan territories.British journal of pain · 2022Article
- Opioids and pituitary function: expert opinion.Pituitary · 2022Review
- The relationship between patients' income and education and their access to pharmacological chronic pain management: A scoping review.Canadian journal of pain = Revue canadienne de la douleur · 2022Article
- Opioid Dosage Levels, Concurrent Risk Factors and Self-Perceptions among Chronic Pain, Opioid-Managed Individuals at Elevated Risk for Opioid Overdose.Pharmaceuticals (Basel, Switzerland) · 2021Article
- Patterns of Routes of Administration and Drug Tampering for Nonmedical Opioid Consumption: Data Mining and Content Analysis of Reddit Discussions.Journal of medical Internet research · 2021Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe risks of harms from opioids increase substantially at high doses, and high-dose prescribing has increased in primary care. However, little is known about what leads to high-dose prescribing, and studies exploring this have not been synthesized. We, therefore, systematically synthesized factors associated with the prescribing of high-dose opioids in primary care.
methodsWe conducted a systematic review of observational studies in high-income countries that used patient-level primary care data and explored any factor(s) in people for whom opioids were prescribed, stratified by oral morphine equivalents (OME). We defined high doses as ≥ 90 OME mg/day. We searched MEDLINE, Embase, Web of Science, reference lists, forward citations, and conference proceedings from database inception to 5 April 2019. Two investigators independently screened studies, extracted data, and appraised the quality of included studies using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. We pooled data on factors using random effects meta-analyses and reported relative risks (RR) or mean differences with 95% confidence intervals (CI) where appropriate. We also performed a number needed to harm (NNT
resultsWe included six studies with a total of 4,248,119 participants taking opioids, of whom 3.64% (n = 154,749) were taking high doses. The majority of included studies (n = 4) were conducted in the USA, one in Australia and one in the UK. The largest study (n = 4,046,275) was from the USA. Included studies were graded as having fair to good quality evidence. The co-prescription of benzodiazepines (RR 3.27, 95% CI 1.32 to 8.13, I
conclusionsHigh doses of opioids are associated with greater risks of harms. Associated factors such as the co-prescription of benzodiazepines and depression identify priority areas that should be considered when selecting, identifying, and managing people taking high-dose opioids in primary care. Coordinated strategies and services that promote the safe prescribing of opioids are needed. STUDY REGISTRATION: PROSPERO, CRD42018088057.
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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 Socratic graph.