{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T02:16:13Z","timestamp":1792548973128,"version":"4.5.0"},"reference-count":35,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Intern Med"],"published-print":{"date-parts":[[2024,5,1]]},"abstract":"<jats:sec id=\"ab-ioi230110-4\"><jats:title>Importance<\/jats:title><jats:p>Although the intention of the 2016 US Centers for Disease Control and Prevention (CDC) Guideline for Prescribing Opioids for Chronic Pain was not to limit pain treatment for patients with sickle cell disease (SCD), clinicians and patients have recognized the possibility that the guideline may have altered outcomes for this population. However, the outcomes of the 2016 guideline for this patient population are unknown.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230110-5\"><jats:title>Objective<\/jats:title><jats:p>To examine changes in opioid prescribing patterns and health outcomes among patients with SCD before and after the release of the 2016 CDC guideline.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230110-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This retrospective cohort study conducted interrupted time series analysis of claims data from the Merative MarketScan Commercial Database from January 1, 2011, to December 31, 2019. In this population-based study in the US, individuals with SCD who were at least 1 year of age, had no cancer diagnosis, and had pharmacy coverage for the month of measurement were included. The data were analyzed from January 2021 to November 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230110-7\"><jats:title>Exposure<\/jats:title><jats:p>The CDC Guideline for Prescribing Opioids for Chronic Pain released in March 2016.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230110-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The main variables measured in this study included the practice of opioid prescribing among patients with SCD (ie, rate of opioid prescriptions dispensed, mean number of days supplied, mean total morphine milligram equivalents [MME] per patient, and mean daily MME per opioid prescription) and pain-related health outcomes (rates of emergency department visits related to vaso-occlusive crises [VOC] and hospitalizations related to VOC).<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230110-9\"><jats:title>Results<\/jats:title><jats:p>The cohort included 14\u202f979 patients with SCD (mean [SD] age, 25.9 [16.9] years; 8520 [56.9%] female). Compared with the preguideline trends, after the guideline was released, there was no change in opioid dispensing rate (\u22120.01 [95% CI, \u22120.04 to 0.02]) prescriptions per 100 person-month;<jats:italic> P<\/jats:italic>\u2009=\u2009.56), but there were significant decreases in the number of days supplied per prescription (\u22120.05 [95% CI, \u22120.06 to \u22120.04] days per prescription-month; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001) and opioid dosage (\u221240.0 [95% CI, \u221260.9 to \u221219.0] MME per person-month; <jats:italic>P<\/jats:italic>\u2009=\u2009.001; \u221210.1 [95% CI, \u221214.6 to \u22125.6] MME\/prescription-month; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001). Conversely, significant increases in VOC-related emergency department visits (0.04 [95% CI, 0.02-0.05] visits per 100 person-month; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001) and hospitalizations (0.07 [95% CI, 0.05-0.1] hospitalizations per 100 person-month; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001) occurred after the guideline release. These changes were observed to a greater extent among adult patients, but pediatric patients experienced similar changes in several measures, even though the guideline focused exclusively on adult patients.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230110-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>This retrospective cohort study showed that the 2016 CDC guideline may have had unintended negative outcomes on the patient population living with SCD.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamainternmed.2023.8538","type":"journal-article","created":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T15:01:56Z","timestamp":1710169316000},"page":"510","source":"Crossref","is-referenced-by-count":29,"title":["Opioid Prescribing and Outcomes in Patients With Sickle Cell Disease Post\u20132016 CDC Guideline"],"prefix":"10.1001","volume":"184","author":[{"given":"Hyeun Ah","family":"Kang","sequence":"first","affiliation":[{"name":"Division of Health Outcomes, College of 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