For patients prescribed long-term opioid therapy (LTOT), opioid tapering may have unintended negative consequences, including more ED visits and hospitalizations, according to a study published in JAMA Network Open. Elizabeth M. Magnan, MD, PhD, and colleagues conducted a retrospective cohort study to examine tapering among adults prescribed stable doses of LTOT at 50 morphine milligram equivalents or more per day during a
12-month baseline period. Data were included for 113,604 patients prescribed LTOT; 41,207 and 23,335 had hypertension and diabetes, respectively. More ED visits and hospitalizations in association with tapering were seen in the overall cohort (adjusted incidence rate ratios [aIRRs], 1.19 and 1.16, respectively), with associations of similar
magnitude noted in the hypertension and diabetes subcohorts. Fewer primary care visits were seen in association with tapering in the overall cohort (aIRR, 0.95) and the hypertension sub-cohort (aIRR, 0.98). Tapering was associated with reduced medication adherence in the hypertension and diabetes subcohorts (aIRRs, 0.60 and 0.69,
respectively) and with small increases in diastolic blood pressure and A1C levels.
