The influence of prescriber and patient gender on the prescription of benzodiazepines: results from the Florida Medicaid Dataset

CNS Spectrums ◽  
2021 ◽  
pp. 1-5
Author(s):  
Leanna M. W. Lui ◽  
Yena Lee ◽  
Orly Lipsitz ◽  
Nelson B. Rodrigues ◽  
Hartej Gill ◽  
...  
Keyword(s):  
The United States ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Assistance Program ◽  
Patient Gender ◽  
Prescription Rates ◽  
Male Patients ◽  
Using Data ◽  
Main Effects

Abstract Background Benzodiazepine (BZD) prescription rates have increased over the past decade in the United States. Available literature indicates that sociodemographic factors may influence diagnostic patterns and/or prescription behaviour. Herein, the aim of this study is to determine whether the gender of the prescriber and/or patient influences BZD prescription. Methods Cross-sectional study using data from the Florida Medicaid Managed Medical Assistance Program from January 1, 2018 to December 31, 2018. Eligible recipients ages 18 to 64, inclusive, enrolled in the Florida Medicaid plan for at least 1 day, and were dually eligible. Recipients either had a serious mental illness (SMI), or non-SMI and anxiety. Results Total 125 463 cases were identified (i.e., received BZD or non-BZD prescription). Main effect of patient and prescriber gender was significant F(1, 125 459) = 0.105, P = 0 .745, partial η2 < 0.001. Relative risk (RR) of male prescribers prescribing a BZD compared to female prescribers was 1.540, 95% confidence intervals (CI) [1.513, 1.567], whereas the RR of male patients being prescribed a BZD compared to female patients was 1.16, 95% CI [1.14, 1.18]. Main effects of patient and prescriber gender were statistically significant F(1, 125 459) = 188.232, P < 0.001, partial η2 = 0.001 and F(1, 125 459) = 349.704, P < 0.001, partial η2 = 0.013, respectively. Conclusions Male prescribers are more likely to prescribe BZDs, and male patients are more likely to receive BZDs. Further studies are required to characterize factors that influence this gender-by-gender interaction.

scholarly journals Global, regional, and national consumption of controlled opioids: a cross-sectional study of 214 countries and non-metropolitan territories

2021 ◽  
pp. 204946372110130
Author(s):  
Georgia C Richards ◽  
Jeffrey K Aronson ◽  
Kamal R Mahtani ◽  
Carl Heneghan
Keyword(s):  
The United States ◽  
Cross Sectional Study ◽  
Opioid Consumption ◽  
Sectional Study ◽  
Total Consumption ◽  
Cross Sectional ◽  
The World ◽  
Narcotics Control ◽  
Using Data ◽  
National Consumption

Introduction: The consumption of opioids has increased globally since the 1990s. Previous studies of global opioid consumption have concentrated on morphine alone or a subset of opioids, with a focus on cancer pain and palliative care. In this study, we have determined the global, regional, and national consumption of all controlled opioids, including anaesthetics, analgesics, antidiarrheals, opioid substitution therapies, and cough suppressants. Methods: We conducted a cross-sectional study using data from the International Narcotics Control Board (INCB). We calculated mean opioid consumption (mg/person) globally, regionally, and nationally for 2015–2017, where consumption refers to the total amount of controlled opioids distributed for medical purposes and excludes recreational use. We ranked countries by total consumption and quantified the types of opioids consumed globally. Results: Between 2015 and 2017, 90% of the world’s population consumed only 11% of controlled opioids. An average of 32 mg/person was consumed annually, but this was not equally distributed across the world. Consumption was the highest in Germany (480 mg/person), followed by Iceland (428 mg/person), the United States (398 mg/person) and Canada (333 mg/person). Oxycodone (35%) was the most heavily consumed controlled opioid globally, followed by morphine (15.9%), methadone (15.8%) and tilidine (14%). Conclusion: Large disparities persist in most of the world in accessing essential opioid medicines. Consumption patterns should continue to be monitored, and collaborative strategies should be developed to promote access and the appropriate prescribing of opioids in all countries and non-metropolitan territories.

scholarly journals Ever Use of E-Cigarettes Among Adults in the United States: A Cross-Sectional Study of Sociodemographic Factors

2019 ◽  
Vol 56 ◽  
pp. 004695801986447 ◽  
Author(s):  
Sericea Stallings-Smith ◽  
Taylor Ballantyne
Keyword(s):  
United States ◽  
High School ◽  
Mexican Americans ◽  
The United States ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Cigarette Use ◽  
Poverty Level ◽  
Cross Sectional ◽  
Nationally Representative

E-cigarette use among adolescents is well-documented, but less is known about adult users of e-cigarettes. The purpose of this study was to examine associations between sociodemographic factors and e-cigarette use in a nationally representative sample of adults in the United States. Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) for years 2015-2016 were analyzed to assess e-cigarette use among 5989 adults aged ≥18 years. Multivariable logistic regression was conducted to examine associations between the sociodemographic exposures of age, sex, race, marital status, education level, employment status, and poverty-income ratio and the outcome of e-cigarette use. The weighted prevalence of ever use of e-cigarettes was 20%. Compared with adults aged ≥55 years, odds of e-cigarette use were 4.77 times (95% confidence interval [CI] = 3.63-6.27) higher among ages 18 to 34 years and 2.16 times (95% CI = 1.49-3.14) higher among ages 35 to 54 years. Higher odds of e-cigarette use were observed among widowed/divorced/separated participants compared with those who were married/living with a partner, among participants with less than high school (odds ratio [OR] = 1.47; 95% CI = 1.08-2.00) or high school/general educational development (GED) education (OR=1.41; 95% CI = 1.12-1.77) compared with those with college degrees/some college, and among those with incomes below the poverty level (OR=1.31; 95% CI = 1.01-1.69) compared with above the poverty level. For non-smokers of conventional cigarettes, higher odds of e-cigarette use were observed among males compared with females, Mexican Americans/Other Hispanics compared with non-Hispanic whites, and non-working participants compared with those who were working. Overall findings indicate that individuals who are widowed/divorced/separated, individuals with lower education, and with incomes below the poverty level are likely to report ever use of e-cigarettes. As increasing evidence demonstrates negative health consequences, e-cigarette initiation may ultimately contribute to additional smoking-related health inequalities even among non-smokers of conventional cigarettes.

scholarly journals Prevalence of Elevated Liver Stiffness Among Potential Candidates for Bariatric Surgery in the United States

2022 ◽  
Author(s):  
Stefano Ciardullo ◽  
Mattia Pizzi ◽  
Pietro Pizzi ◽  
Alice Oltolini ◽  
Emanuele Muraca ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Liver Disease ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
The United States ◽  
Cross Sectional Study ◽  
Metabolic Dysfunction ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Using Data

Abstract Purpose Obesity represents a well-known risk factor for metabolic-dysfunction associated fatty liver disease (MAFLD) and its progression towards cirrhosis. The aim of this study is to estimate the proportion of potential candidates to a bariatric surgery intervention that has an elevated liver stiffness on vibration-controlled transient elastography (VCTE). Materials and Methods This is a cross-sectional study performed using data obtained during the 2017–2018 cycle of the National Health and Nutrition Examination Survey. Potential candidates for a bariatric surgery intervention from the general US population were identified by applying criteria from international guidelines. All included participants were evaluated by VCTE. A controlled attenuation parameter (CAP) value ≥ 288 dB/m was considered indicative of steatosis while liver stiffness measurement (LSM) was considered elevated if ≥ 9.7 kPa. Multivariable logistic regression models were fitted to identify independent predictors of both outcomes. Results A total of 434 participants were included (mean age 42.9 ± 0.6 years; 54.4% women). Among them, 76.7% (95% CI 71.7–81.0) had steatosis, while 23.1% (95% CI 17.8–29.3) had an elevated LSM. Male sex, older age, γ-glutamyltranspeptidase levels, and body mass index (BMI) were independent predictors of steatosis, while BMI was the only independent predictor of elevated LSM. Non-Hispanic black participants were protected from both outcomes, while other ethnicities were not. Conclusion The prevalence of elevated LSM is high in potential candidates for a bariatric surgery intervention. Accurate screening for occult advanced liver disease might be indicated in this patient population. Graphical abstract

Direct and Indirect Violence Exposure: Relations to Depression for Economically Disadvantaged Ethnic Minority Mid-Adolescents

2015 ◽  
Vol 30 (1) ◽  
pp. 120-135 ◽  
Author(s):  
Kathan Dushyant Shukla ◽  
Margit Wiesner
Keyword(s):  
Economically Disadvantaged ◽  
Violence Exposure ◽  
Public Health Problem ◽  
Exposure To Violence ◽  
The United States ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Witnessing Violence ◽  
Using Data ◽  
Cumulative Violence

Exposure to violence remains a considerable public health problem for adolescents in the United States. This cross-sectional study examined relative associations between exposure to violence in 3 different contexts (home, school, community) and depressive symptoms, using data from 233 11th-graders (predominantly economically disadvantaged Hispanic and African American students). Analyses examined the effects of victimization and witnessing violence in each context and those of cumulative violence exposure across contexts on depression, controlling for other risk factors. Both victimization and witnessing violence at home significantly predicted depression. Violence exposure in school and neighborhood was unrelated to the outcome. Witnessing violence was slightly more effective in predicting depression than victimization. Cumulative violence exposure was significantly related to depression in a linear fashion.

scholarly journals Administering the Sarcoidosis Health Questionnaire to sarcoidosis patients in Serbia

2016 ◽  
Vol 42 (2) ◽  
pp. 99-105
Author(s):  
Violeta Mihailović-Vučinić ◽  
Branislav Gvozdenović ◽  
Mihailo Stjepanović ◽  
Mira Vuković ◽  
Ljiljana Marković-Denić ◽  
...  
Keyword(s):  
United States ◽  
Health Status ◽  
The United States ◽  
Cross Sectional Study ◽  
Self Report ◽  
Health Questionnaire ◽  
Cross Sectional ◽  
Language Version ◽  
Patient Gender ◽  
Disease Specific

Objective: The aim of this study was to use a Serbian-language version of the disease-specific, self-report Sarcoidosis Health Questionnaire (SHQ), which was designed and originally validated in the United States, to assess health status in sarcoidosis patients in Serbia, as well as validating the instrument for use in the country. Methods: This was a cross-sectional study of 346 patients with biopsy-confirmed sarcoidosis. To evaluate the health status of the patients, we used the SHQ, which was translated into Serbian for the purposes of this study. We compared SHQ scores by patient gender and age, as well as by disease duration and treatment. Lower SHQ scores indicate poorer health status. Results: The SHQ scores demonstrated differences in health status among subgroups of the sarcoidosis patients evaluated. Health status was found to be significantly poorer among female patients and older patients, as well as among those with chronic sarcoidosis or extrapulmonary manifestations of the disease. Monotherapy with methotrexate was found to be associated with better health status than was monotherapy with prednisone or combination therapy with prednisone and methotrexate. Conclusions: The SHQ is a reliable, disease-specific, self-report instrument. Although originally designed for use in the United States, the SHQ could be a useful tool for the assessment of health status in various non-English-speaking populations of sarcoidosis patients.

scholarly journals Nonlinear association between blood lead and hyperhomocysteinemia among adults in the United States

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Minghui Li ◽  
Lihua Hu ◽  
Wei Zhou ◽  
Tao Wang ◽  
Lingjuan Zhu ◽  
...  
Keyword(s):  
Positive Association ◽  
Blood Lead ◽  
Absorption Spectrometry ◽  
The United States ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Health And Nutrition ◽  
Increased Risk ◽  
Lead Levels ◽  
Using Data

Abstract Evidence regarding the association between blood lead levels (BLL) and hyperhomocysteinemia (HHcy) in US adults was limited. We aimed to investigate the association of BLL with the risk of HHcy, and to examine possible effect modifiers using US National Health and Nutrition Examination Survey (NHANES) database. We performed a cross-sectional study using data from up to 9,331 participants aged ≥ 20 years of NHANES from 2001 to 2006. BLL was measured by atomic absorption spectrometry. HHcy was defined as plasma homocysteine level > 15 µmol/L. The weighted prevalence of HHcy was 6.87%. The overall mean BLL was 1.9 μg/dL. Overall, there was a nonlinear positive association between Ln-transformed BLL (LnBLL) and the risk of HHcy. The Odds ratios (95% CI) for participants in the second (0.04–0.49 μg/dL), third (0.5–0.95 μg/dL) and fourth quartiles (> 0.95 μg/dL) were 1.12 (95% CI: 0.71, 1.76), 1.13 (95% CI: 0.73, 1.77), and 1.67 (95% CI: 1.07, 2.61), respectively, compared with those in quartile 1. Consistently, a significantly higher risk of HHcy (OR: 1.49; 95% CI: 1.19, 1.88) was found in participants in quartile 4 compared with those in quartiles 1–3. Furthermore, a strongly positive association between LnBLL and HHcy was observed in participants with estimated glomerular filtration rate (eGFR) < 60 mL/min−1/1.73 m−2. Our results suggested that a higher level of BLL (LnBLL > 0.95 μg/dL) was associated with increased risk of HHcy compared with a lower level of BLL (LnBLL ≤ 0.95 μg/dL) among U.S. adults, and the association was modified by the eGFR.

Blood Dehydroepiandrosterone and Dehydroepiandrosterone Sulfate as Pathophysiological Correlates of Chronic Pain: Analyses Using a National Sample of Midlife Adults in the United States

Pain Medicine ◽  
2020 ◽  
Author(s):  
Rui Li ◽  
Benjamin P Chapman ◽  
Shannon M Smith
Keyword(s):  
United States ◽  
Chronic Pain ◽  
Dehydroepiandrosterone Sulfate ◽  
The United States ◽  
National Sample ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Using Data ◽  
Midlife Adults

Abstract Objective Identifying biomarkers is a priority in translational chronic pain research. Dehydroepiandrosterone (DHEA) and its sulfated form, DHEA-S, are adrenocortical steroids in the blood with neuroprotective properties that also produce sex hormones. They may capture key sex-specific neuroendocrine mechanisms of chronic pain. Design Cross-sectional study. Methods Using data from 1,216 community-dwelling adults aged 34–84 from the Midlife in the United States (MIDUS) cohort, we examined blood DHEA and DHEA-S levels in association with chronic pain in men and women, adjusting for demographics, chronic diseases, medications including opioids, and psychosocial factors. If an association was found, we further explored dose-response relationships by the number of pain locations and the degree of pain interference. Results In women, chronic pain was associated with 0.072 lower (95% confidence interval [CI], –0.127 to –0.017) log10 DHEA-S µg/dL, with pain in one to two locations associated with 0.068 lower (95% CI, –0.131 to –0.006) and in three or more locations 0.071 lower (95% CI, –0.148 to 0.007) log10 DHEA-S (P for trend = 0.074). Furthermore for women, low-interference pain was associated with 0.062 lower (95% CI, –0.125 to –0.000), whereas high-interference pain was associated with 0.138 lower (95% CI, –0.233 to –0.043) log10 DHEA-S (P for trend = 0.004). Chronic pain was not associated with DHEA or DHEA-S levels in men or DHEA levels in women. Conclusions Chronic pain and its functional interference correspond to lower blood DHEA-S levels in women.

Sociodemographic Factors, Population Density, and Bicycling for Transportation in the United States

2016 ◽  
Vol 13 (1) ◽  
pp. 36-43 ◽  
Author(s):  
Eileen K. Nehme ◽  
Adriana Pérez ◽  
Nalini Ranjit ◽  
Benjamin C. Amick ◽  
Harold W. Kohl
Keyword(s):  
United States ◽  
Population Density ◽  
The United States ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Household Travel Survey ◽  
Typical Day ◽  
Household Travel ◽  
National Household Travel Survey

Background:Transportation bicycling is a behavior with demonstrated health benefits. Population-representative studies of transportation bicycling in United States are lacking. This study examined associations between sociodemographic factors, population density, and transportation bicycling and described transportation bicyclists by trip purposes, using a US-representative sample.Methods:This cross-sectional study used 2009 National Household Travel Survey datasets. Associations among study variables were assessed using weighted multivariable logistic regression.Results:On a typical day in 2009, 1% of Americans older than 5 years of age reported a transportation bicycling trip. Transportation cycling was inversely associated with age and directly with being male, with being white, and with population density (≥ 10,000 vs < 500 people/square mile: odd ratio, 2.78, 95% confidence interval, 1.54–5.05). Those whose highest level of education was a high school diploma or some college were least likely to bicycle for transportation. Twenty-one percent of transportation bicyclists reported trips to work, whereas 67% reported trips to social or other activities.Conclusions:Transportation bicycling in the United States is associated with sociodemographic characteristics and population density. Bicycles are used for a variety of trip purposes, which has implications for transportation bicycling research based on commuter data and for developing interventions to promote this behavior.

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