{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T14:16:58Z","timestamp":1780064218433,"version":"3.54.0"},"reference-count":48,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,6,4]],"date-time":"2018-06-04T00:00:00Z","timestamp":1528070400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["1R56NR015498\u201001"],"award-info":[{"award-number":["1R56NR015498\u201001"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["1F31AG056078\u201001"],"award-info":[{"award-number":["1F31AG056078\u201001"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To estimate the proportion of residents newly initiating long\u2010acting opioids in comparison to residents initiating short\u2010acting opioids and examine variation in long\u2010acting opioid initiation by region and resident characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross\u2010sectional study included 182\u00a0735 long\u2010stay nursing home residents in 13\u00a0881 US nursing homes who were Medicare beneficiaries during 2011 to 2013 and initiated a short\u2010acting or long\u2010acting opioid (excluding residents &lt;50\u00a0years old, those with cancer, or receiving hospice care). Medicare Part D prescription claims were used to identify residents as newly initiating short\u2010acting or long\u2010acting opioids, defined as having a prescription claim for an opioid with no prior opioid prescriptions in the preceding 60\u00a0days. We estimated the overall proportion of initiators prescribed long\u2010acting opioids. Regional variation was examined by mapping results by state and hospital referral regions. Logistic models were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two percent of opioid initiators were prescribed long\u2010acting opioids. State variation in long\u2010acting opioid initiation ranged from 0.6% to 7.5% (5th\u201095th percentiles: 0.6\u20106.4%). Resident characteristics associated with increased long\u2010acting opioid initiation included severe physical limitations (vs none\/mild limitations; aOR: 2.13, 95% CI: 1.92\u20102.37) and pain (staff\u2010assessed vs no pain; aOR: 1.59 95% CI: 1.40\u20101.80), whereas being non\u2010White was inversely associated (non\u2010Hispanic black vs non\u2010Hispanic white; aOR: 0.70, 95% CI: 0.62\u20100.79).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>United States nursing home residents predominantly initiate short\u2010acting opioids in accordance with Center for Disease Control and Prevention guidelines. Documented variation by geographic and resident characteristics suggests that improvements are possible.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.4568","type":"journal-article","created":{"date-parts":[[2018,6,5]],"date-time":"2018-06-05T06:04:07Z","timestamp":1528178647000},"page":"31-38","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Long\u2010acting opioid initiation in US nursing homes"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2768-0272","authenticated-orcid":false,"given":"Jacob N.","family":"Hunnicutt","sequence":"first","affiliation":[{"name":"Department of Quantitative Health Sciences University of Massachusetts Medical School  Worcester MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne L.","family":"Hume","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy University of Rhode Island  Kingston RI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine M.","family":"Ulbricht","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences University of Massachusetts Medical School  Worcester MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Tjia","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences University of Massachusetts Medical School  Worcester MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate L.","family":"Lapane","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences University of Massachusetts Medical School  Worcester MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,6,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.1464"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.8071"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.7789"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2009.02376.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1507771"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2010.03847.x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15080"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2014.06.013"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afv184"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajag.12295"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14306"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2016.08.015"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2008.11.008"},{"key":"e_1_2_9_15_1","unstructured":"SalibaD BuchananJ.Development and validation of a revised nursing home assessment tool: MDS 3.0. 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