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Am Fam Physician. 2022;105(4):362

What are the risks of tapering chronic opioids?

According to an observational study, patients with tapered opioid doses are more likely to present with drug overdose or withdrawal in the subsequent 12 months compared with patients maintained on their chronic opioid regimen (9.3 overdose events per 100 person-years compared with 5.5 events per 100 person-years). Patients with tapered opioid doses were also more likely to present with mental health crises (i.e., depression, anxiety, or suicide) than patients maintained on their chronic opioid regimen. As we await further research, tapering chronic opioid doses can still be a useful tool if we proceed slowly and engage in thoughtful patient-centered decision-making regarding its potential risks.

Does community vision screening in patients 65 years and older reduce the prevalence of visual impairment?

The available evidence does not support screening adults 65 years and older for visual impairment in the primary care setting. Among community-dwelling adults in this age group, vision screening produces no significant difference in the prevalence of visual impairment at follow-up compared with no screening.

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