{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T06:46:57Z","timestamp":1785912417112,"version":"3.56.0"},"reference-count":42,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,10,26]],"date-time":"2022-10-26T00:00:00Z","timestamp":1666742400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R24AG064025"],"award-info":[{"award-number":["R24AG064025"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A limited number of studies have analyzed prescribing among Medicare\u2010enrolled adults at risk for opioid overdoses. The objectives of this study were to evaluate prescribing for naloxone and central nervous system (CNS) active medications and to determine the relationships of patient characteristics with exposure to these medications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective cross\u2010sectional analysis of a Medicare\u2010enrolled medication therapy management eligible cohort. Patients were stratified into two cohorts, individuals with a mean daily morphine milligram equivalent (MME) dose &lt;50 and individuals with MME \u226550. Medications assessed included benzodiazepines, skeletal muscle relaxants (SMR), hypnotics, gabapentanoids, selective\u2010serotonin reuptake inhibitors (SSRI), serotonin\u2013norepinephrine reuptake inhibitors (SNRI), tricyclic antidepressants (TCA), antipsychotics, barbiturates, other antiepileptics, hydroxyzine, and naloxone. Chi\u2010square with odds ratios and logistic regressions determined the relationships of medications and patient characteristics with mean daily MME \u226550. Relationship between medications and opioid dose was adjusted for age and sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 3452 patients with a daily MME &lt;50 and 1116 with a daily MME \u226550. After adjusting for age and sex, patients with a daily MME \u226550 were more likely to be prescribed hypnotics (OR: 1.41, 95% CI 1.17\u20131.70), SNRIs (OR: 1.39, 95% CI 1.17\u20131.64), and naloxone (OR: 3.21, 95% CI 2.49\u20134.12) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Nine percent of eligible patients received naloxone. Age groups of persons &lt;85\u2009years of age had 1.58\u20134.04 (p\u2009\u2264\u20090.004) times the odds of being prescribed a mean daily MME \u226550.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Nearly one\u2010fourth of patients were prescribed a mean daily opioid therapy of MME \u226550. These patients were more likely to be prescribed hypnotics, SNRIs, and naloxone. Patients receiving chronic high\u2010dose opioid therapy were more likely to be in age groups of persons &lt;85\u2009years. Naloxone may be underprescribed among eligible adults. Targeted medication services may ensure optimal prescribing among Medicare patients with chronic opioid therapies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.18102","type":"journal-article","created":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T00:09:41Z","timestamp":1666829381000},"page":"98-108","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["High opioid doses, naloxone, and central nervous system active medications received by\n                    <scp>Medicare\u2010enrolled<\/scp>\n                    adults"],"prefix":"10.1111","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9601-9413","authenticated-orcid":false,"given":"Armando","family":"Silva Almod\u00f3var","sequence":"first","affiliation":[{"name":"College of Pharmacy Institute of Therapeutic Innovations and Outcomes (ITIO), The Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1936-0666","authenticated-orcid":false,"given":"Milap C.","family":"Nahata","sequence":"additional","affiliation":[{"name":"College of Pharmacy Institute of Therapeutic Innovations and Outcomes (ITIO), The Ohio State University  Columbus Ohio USA"},{"name":"College of Medicine The Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,26]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.Rr6501e1"},{"key":"e_1_2_12_3_1","unstructured":"United States Food and Drug Administration.FDA drug safety communication: FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines; requires its strongest warning. United States Food and Drug Administration Web site. Updated 2016. Accessed July 13 2022.https:\/\/www.fda.gov\/drugs\/drug-safety-and-availability\/fda-drug-safety-communication-fda-warns-about-serious-risks-and-death-when-combining-opioid-pain-or"},{"key":"e_1_2_12_4_1","unstructured":"Announcement of calendar year (CY) 2020 Medicare advantage capitation rates and Medicare advantage and part D payment policies and final call letter. The Centers for Medicare and Medicaid Services.2019."},{"key":"e_1_2_12_5_1","unstructured":"GiroirB.HHS recommends prescribing or co\u2010prescribing naloxone to patients at high risk for an opioid overdose. HHS.gov U.S. Department of Health & Human Services Web site. Updated 2018. 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