{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T17:14:46Z","timestamp":1770225286520,"version":"3.49.0"},"reference-count":56,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2021,12,17]],"date-time":"2021-12-17T00:00:00Z","timestamp":1639699200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000133","name":"agency for healthcare research and quality","doi-asserted-by":"publisher","award":["K12HS019461"],"award-info":[{"award-number":["K12HS019461"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"national institute on drug abuse","doi-asserted-by":"publisher","award":["K23DA048182"],"award-info":[{"award-number":["K23DA048182"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>Chronic liver disease (CLD) is among the strongest risk factors for adverse prescription opioid-related events. Yet, the current prevalence and factors associated with high-risk opioid prescribing in patients with chronic liver disease (CLD) remain unclear, making it challenging to address opioid safety in this population. Therefore, we aimed to characterize opioid prescribing patterns among patients with CLD.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort study included patients with CLD identified at a single medical center and followed for one year from 10\/1\/2015-9\/30\/2016. Multivariable, multinomial regression was used identify the patient characteristics, including demographics, medical conditions, and liver-related factors, that were associated with opioid prescriptions and high-risk prescriptions (\u226590mg morphine equivalents per day [MME\/day] or co-prescribed with benzodiazepines).<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>Nearly half (47%) of 12,425 patients with CLD were prescribed opioids over a one-year period, with 17% of these receiving high-risk prescriptions. The baseline factors significantly associated with high-risk opioid prescriptions included female gender (adjusted incident rate ratio, AIRR = 1.32, 95% CI = 1.14\u20131.53), Medicaid insurance (AIRR = 1.68, 95% CI = 1.36\u20132.06), cirrhosis (AIRR = 1.22, 95% CI = 1.04\u20131.43) and baseline chronic pain (AIRR = 3.40, 95% CI = 2.94\u20134.01), depression (AIRR = 1.93, 95% CI = 1.60\u20132.32), anxiety (AIRR = 1.84, 95% CI = 1.53\u20132.22), substance use disorder (AIRR = 2.16, 95% CI = 1.67\u20132.79), and Charlson comorbidity score (AIRR = 1.27, 95% CI = 1.22\u20131.32). Non-alcoholic fatty liver disease was associated with decreased high-risk opioid prescriptions (AIRR = 0.56, 95% CI = 0.47\u20130.66).<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusion<\/jats:title><jats:p>Opioid medications continue to be prescribed to nearly half of patients with CLD, despite efforts to curtail opioid prescribing due to known adverse events in this population.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0261377","type":"journal-article","created":{"date-parts":[[2021,12,17]],"date-time":"2021-12-17T18:45:38Z","timestamp":1639766738000},"page":"e0261377","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Characteristics of opioid prescribing to outpatients with chronic liver diseases: A call for action"],"prefix":"10.1371","volume":"16","author":[{"given":"Olufunso M.","family":"Agbalajobi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"Gmelin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7163-2062","authenticated-orcid":true,"given":"Andrew M.","family":"Moon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wheytnie","family":"Alexandre","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walid F.","family":"Gellad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6859-2909","authenticated-orcid":true,"given":"Naudia","family":"Jonassaint","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8184-1546","authenticated-orcid":true,"given":"Shari S.","family":"Rogal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,12,17]]},"reference":[{"key":"pone.0261377.ref001","unstructured":"Centers for Disease Control and Prevention. 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