{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:40:19Z","timestamp":1792172419852,"version":"4.4.0"},"reference-count":78,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,12,18]],"date-time":"2019-12-18T00:00:00Z","timestamp":1576627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2TR002367"],"award-info":[{"award-number":["KL2TR002367"]}],"id":[{"id":"10.13039\/100006108","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":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This review sought to (a) describe definitions of long\u2010term opioid therapy (LTOT) outcome measures, and (b) identify the predictors associated with the transition from short\u2010term opioid use to LTOT for opioid\u2010na\u00efve individuals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a systematic review of the peer\u2010reviewed literature (January 2007 to July 2018). We included studies examining opioid use for more than 30 days. We classified operationalization of LTOT based on criteria used in the definitions. We extracted LTOT predictors from multivariate models in studies of opioid\u2010na\u00efve individuals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The search retrieved 5,221 studies, and 34 studies were included. We extracted 41 unique variations of LTOT definitions. About 36% of definitions required a cumulative duration of opioid use of 3 months. Only 17% of definitions considered consecutive observation periods, 27% used days' supply, and no definitions considered dose.<\/jats:p><jats:p>We extracted 76 unique predictors of LTOT from seven studies of opioid\u2010na\u00efve patients. Common predictors included pre\u2010existing comorbidities (21.1%), non\u2010opioid prescription medication use (13.2%), substance use disorders (10.5%), and mental health disorders (10.5%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Most LTOT definitions aligned with the chronic pain definition (pain more than 3 months), and used cumulative duration of opioid use as a criterion, although most did not account for consistent use. Definitions were varied and rarely accounted for prescription characteristics, such as days' supply. Predictors of LTOT were similar to known risk factors of opioid abuse, misuse, and overdose. As LTOT becomes a central component of quality improvement efforts, researchers should incorporate criteria to identify consistent opioid use to build the evidence for safe and appropriate use of prescription opioids.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.4929","type":"journal-article","created":{"date-parts":[[2019,12,18]],"date-time":"2019-12-18T18:28:38Z","timestamp":1576693718000},"page":"252-269","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":114,"title":["Long\u2010term opioid therapy definitions and predictors: A systematic review"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0022-0946","authenticated-orcid":false,"given":"Ruchir N.","family":"Karmali","sequence":"first","affiliation":[{"name":"Department of Population Health Sciences Duke University School of Medicine  Durham NC USA"},{"name":"Duke Clinical Research Institute Duke University  Durham NC USA"},{"name":"Department of Health Policy and Management University of North Carolina Gillings School of Global Public Health  Chapel Hill NC USA"},{"name":"Division of Research Kaiser Permanente North California  Oakland, CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Bush","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences Duke University School of Medicine  Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudha R.","family":"Raman","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences Duke University School of Medicine  Durham NC USA"},{"name":"Duke Clinical Research Institute Duke University  Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia I.","family":"Campbell","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente North California  Oakland, CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asheley C.","family":"Skinner","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences Duke University School of Medicine  Durham NC USA"},{"name":"Duke Clinical Research Institute Duke University  Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew W.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Population Health University of Kansas Medical Center  Kansas City KS USA"},{"name":"Department of Anesthesiology University of Kansas Medical Center  Kansas City KS USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6736a2"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/876306"},{"issue":"3","key":"e_1_2_9_4_1","article-title":"Prepared by the International Association for the Study of Pain, Subcommittee on Taxonomy","author":"International Association for the Study of Pain. 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