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The following is a summary of “Association of Opioid Tapering with Pain-Related Emergency Department Visits, Hospitalizations, and Primary Care Visits: A Retrospective Cohort Study,” published in the November 2024 issue of Pain by Magnan et al. 

Researchers conducted a retrospective study to examine the linkage between opioid dose tapering and subsequent pain-related healthcare utilization, including hospitalizations, ED, and primary care visits.  

They used data from the Optum Labs Data Warehouse (2015–2019), which included de-identified administrative claims data for commercial and Medicare Advantage enrollees in the US. Adults of ≥18 years who were prescribed stable doses of opioids (≥50 morphine milligram equivalents [MME]/day) during a 12-month baseline period were included. Tapering was defined as a ≥15% relative decrease in mean daily opioid dose over 1 of 6 overlapping 60-day periods. Tapered patient-periods were divided as tapered-and-continued (MME > 0) or tapered-and-discontinued (MME = 0). The negative binomial regression was used to model monthly pain-related visits over 12 months after cohort entry, adjusting for tapering, baseline utilization, and patient-level covariates.  

The results showed that, among 47,033 patients, 13,793 patients underwent opioid tapering. Compared to no tapering, any tapering was linked to increased ED visits for pain (aIRR 1.21, 95% CI: 1.11–1.30). The tapered-and-continued group had more ED visits (aIRR 1.23, CI: 1.14–1.32) and hospitalizations (aIRR 1.14, CI: 1.03–1.27) for pain. The tapered-and-discontinued group had fewer primary care visits for pain (aIRR 0.68, CI: 0.61–0.76).  

Investigators concluded the opioid tapering might be associated with increased emergency and hospital utilization for acute pain and decreased perceived need for primary care, particularly among those whose opioids were discontinued. 

Source: academic.oup.com/painmedicine/advance-article-abstract/doi/10.1093/pm/pnae121/7908403