{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:27:14Z","timestamp":1791581234273,"version":"4.3.4"},"reference-count":50,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:00:00Z","timestamp":1733011200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:00:00Z","timestamp":1733011200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K24AG073527"],"award-info":[{"award-number":["K24AG073527"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG081268"],"award-info":[{"award-number":["R01AG081268"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG081412"],"award-info":[{"award-number":["R01AG081412"]}],"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":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adults with Alzheimer's disease and Alzheimer's disease related dementias (ADRD) or frailty are susceptible to fractures. Opioid analgesics are frequently prescribed after fractures. Documenting post\u2010fracture opioid discontinuation rates and predictors of discontinuation among adults with ADRD or frailty can inform clinical practice, identify potential disparities, and improve pain management guidelines. The objective of this paper was to investigate opioid discontinuation in opioid\u2010na\u00efve older adults who used opioids after an acute fracture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study included opioid\u2010na\u00efve Medicare fee\u2010for\u2010service beneficiaries (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200933,027) \u226565\u2009years of age who filled an opioid prescription within 30\u2009days of a vertebral, lower extremity, or upper extremity fracture from 2013 to 2018. Beneficiaries were classified according to ADRD (yes\/no) and frailty (yes\/no) status using validated claims\u2010based algorithms. The primary outcome was opioid discontinuation, defined as a 30\u2010day supply gap. We estimated discontinuation rates with the Kaplan\u2013Meier method and identified predictors of opioid discontinuation using Cox proportional hazards regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 30\u2010day opioid discontinuation rate was similar among non\u2010frail beneficiaries without ADRD (81% [95% CI, 80%\u201381%]) and those who were non\u2010frail with ADRD (83% [81%\u201384%]). Comparatively, 30\u2010day discontinuation rates were lower among those with frailty and ADRD (76% [75%\u201377%]) and those with frailty alone (77% [75%\u201378%]). After adjusting for sociodemographic characteristics, health status, healthcare utilization, and calendar year, beneficiaries with both ADRD and frailty (HR, 0.90 [0.87\u20130.93]) and those with frailty alone (HR, 0.85 [0.82\u20130.89]), but not those with ADRD alone (HR, 1.06 [1.01\u20131.10]), were less likely to discontinue opioids compared with those without ADRD or frailty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>Our findings suggest that frailty, but not ADRD, was associated with a lower likelihood of opioid discontinuation among older adults who initiated opioids after an acute fracture. Further research is needed to understand how opioid deprescribing practices depend on patient and provider preferences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.19290","type":"journal-article","created":{"date-parts":[[2024,12,2]],"date-time":"2024-12-02T01:43:11Z","timestamp":1733103791000},"page":"737-749","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Rates and predictors of opioid deprescribing after fracture: A retrospective study of Medicare fee\u2010for\u2010service claims"],"prefix":"10.1111","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3836-2440","authenticated-orcid":false,"given":"Kevin T.","family":"Pritchard","sequence":"first","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun\u2010Ting","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiaoxi","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yichi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M.","family":"Wilkins","sequence":"additional","affiliation":[{"name":"Division of Geriatric Psychiatry McLean Hospital, Harvard Medical School  Belmont Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7290-6838","authenticated-orcid":false,"given":"Dae Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Hinda and Arthur Marcus Institute for Aging Research, Hebrew Senior Life Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Gerontology, Department of Medicine Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kueiyu Joshua","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Medicine, Massachusetts General Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,1]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17281"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2018.09.024"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2023.03.012"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000001392"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.17.01645"},{"key":"e_1_2_9_7_1","doi-asserted-by":"crossref","unstructured":"OPEN: Opioid Prescribing Engagement Network.OPEN Prescribing Recommendations. Accessed August 2021. doi:10.56137\/OPEN.000054","DOI":"10.56137\/OPEN.000054"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.15638"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.7280"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15332"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-052057"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/ANA.0000000000000682"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000003141"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2021.01.086"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.12.023"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2023.01.069"},{"key":"e_1_2_9_17_1","unstructured":"U.S. Department of Health and Human Services.Pain Management Best Practices Inter\u2010Agency Task Force Report: Updates Gaps Inconsistencies and Recommendations. Accessed February 26 2024.https:\/\/www.hhs.gov\/sites\/default\/files\/pain-mgmt-best-practices-draft-final-report-05062019.pdf"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2020.04.029"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trci.2018.10.012"},{"key":"e_1_2_9_20_1","unstructured":"Chronic Conditions Warehouse.Medicare Administrative Data User Guide Version 3.9. Accessed February 2024.https:\/\/www2.ccwdata.org\/documents\/10280\/19002246\/ccw-medicare-data-user-guide.pdf"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.7326\/M18-3079"},{"key":"e_1_2_9_22_1","unstructured":"U.S Department of Health and Human Services and Food and Drug Administration.National Drug Code Directory. Accessed October 17 2023.https:\/\/www.accessdata.fda.gov\/scripts\/cder\/ndc\/index.cfm"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.3807"},{"key":"e_1_2_9_24_1","unstructured":"National Bureau of Economic Research.ICD\u20109\u2010CM to and from ICD\u201010\u2010CM and ICD\u201010\u2010PCS crosswalk or general equivalence mappings.2023Accessed October 17 2023 https:\/\/www.nber.org\/research\/data\/icd\u20109\u2010cm\u2010and\u2010icd\u201010\u2010cm\u2010and\u2010icd\u201010\u2010pcs\u2010crosswalk\u2010or\u2010general\u2010equivalence\u2010mappings"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2022.5153"},{"key":"e_1_2_9_26_1","unstructured":"U.S. Department of Agriculture.Measuring Rurality: Rural\u2010Urban Continuum Codes. Accessed July 26 2022.https:\/\/www.ers.usda.gov\/data\u2010products\/rural\u2010urban\u2010continuum\u2010codes\/documentation\/"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.10.004"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.9679"},{"key":"e_1_2_9_29_1","first-page":"e220653","volume-title":"Evaluation of Claims\u2010Based Ascertainment of Alzheimer Disease and Related Dementias across Health Care Settings","author":"Festa N","year":"2022"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glx229"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/gly197"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glae094"},{"key":"e_1_2_9_33_1","unstructured":"Agency for Healthcare Research and Quality.Clinical Classifications Software (CCS). Accessed October 2023.https:\/\/hcup-us.ahrq.gov\/toolssoftware\/ccs\/ccs.jsp#overview"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2019.01.003"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2023.06.039"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.40612"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0006-341X.2000.00779.x"},{"issue":"163","key":"e_1_2_9_39_1","article-title":"Schedules of controlled substances: rescheduling of hydrocodone combination products from schedule III to schedule II. Final rule","volume":"79","author":"Drug Enforcement Administration DoJ","year":"2014","journal-title":"Fed Regist"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.1464"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1177\/0033354919892638"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000029944"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17653"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1953.tb01117.x"},{"key":"e_1_2_9_45_1","unstructured":"Centers for Medicare and Medicaid Services.Guiding an Improved Dementia Experience (GUIDE) Model. Accessed August 1 2024.https:\/\/www.cms.gov\/priorities\/innovation\/innovation-models\/guide"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-026308"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2011.03698.x"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa020423"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.13561"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph191711021"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.7326\/M16-2607"}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.19290","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgs.19290","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.19290","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T16:50:45Z","timestamp":1776358245000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.19290"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,1]]},"references-count":50,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1111\/jgs.19290"],"URL":"https:\/\/doi.org\/10.1111\/jgs.19290","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"value":"0002-8614","type":"print"},{"value":"1532-5415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,1]]},"assertion":[{"value":"2024-05-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}