scholarly journals Opioid Analgesic Prescribing Practices of Dental Professionals in the United States

2017 ◽  
Vol 2 (3) ◽  
pp. 241-248 ◽  
Author(s):  
C.N. Steinmetz ◽  
C. Zheng ◽  
E. Okunseri ◽  
A. Szabo ◽  
C. Okunseri
Keyword(s):  
United States ◽  
Opioid Analgesic ◽  
Personal Characteristics ◽  
Opioid Analgesics ◽  
The United States ◽  
Medical Expenditure ◽  
Dental Procedure ◽  
Prescribing Practices ◽  
Over Time ◽  
Dental Professionals

The prescription of opioid analgesics by dental professionals is widespread in the United States. Policy makers, government agencies, and professional organizations consider this phenomenon a growing public health concern. This study examined trends in the prescription of opioid analgesics for adults by dental professionals and associated factors in the United States. Data from the Medical Expenditure Panel Survey (1996-2013) were analyzed. Descriptive statistics were calculated separately for each year. Logistic regression analyses were conducted to estimate the overall trend during the period with and without adjusting for dental procedures and personal characteristics. Survey weights were incorporated to handle the sampling design. The prescription of opioid analgesics following dental care increased over time. After adjusting for sociodemographic factors, source of payment, and type of dental procedure, the odds ratio (OR) of prescribing opioid analgesics following a dental visit per each decade difference was 1.28 (95% confidence interval [CI], 1.19–1.38). Surgical, root canal, and implant procedures had the highest rates of opioid prescriptions and the greatest increases in rates over the study period. After adjusting for personal characteristics and type of dental procedure, the OR of receiving a prescription for opioids comparing blacks, Asians, and Hispanics to whites was 1.29 (95% CI, 1.17–1.41), 0.57 (95% CI, 0.47–0.70), and 0.84 (95% CI, 0.75–0.95), respectively. Opioid analgesic prescriptions following dental visits increased over time after adjusting for personal characteristics and type of dental procedure. The odds of receiving a prescription for opioids were higher for certain racial/ethnic minority groups. Knowledge Transfer Statement: This study highlights dental professionals prescribing practices of opioid analgesics by following dental treatments in the United States. With this knowledge, appropriate guidelines, protocols, and policies can be developed and implemented to address any inappropriate prescribing practices of opioid analgesics. In addition, this information could lead to an improvement in the prescribing practices of dental professionals and to evidence-based therapeutic decision making.

scholarly journals Clinical Preventive Services and Self-Management Practices Among Adult Cancer Survivors in the United States Over Time

2021 ◽  
Vol 28 ◽  
pp. 107327482110591
Author(s):  
Patricia A. Findley ◽  
R. Constance Wiener ◽  
Chan Shen ◽  
Nilajana Dwibedi ◽  
Usha Sambamoorthi
Keyword(s):  
United States ◽  
Physical Examination ◽  
Cancer Survivors ◽  
The United States ◽  
Normal Weight ◽  
Medical Expenditure ◽  
Dental Visit ◽  
Influenza Immunization ◽  
Health Promoting ◽  
Over Time

The objective of this research was to determine if the engagement/participation in health promotion activities of cancer survivors in the United States (US) changed between 2006 and 2015. We pooled two independent cross-sectional data of cancer survivors using Medical Expenditure Panel Surveys from 2006 (N = 791; weighted N = 9,532,674) and 2015 (N = 1067; weighted N = 15,744,959). Health promoting activities consisted of past year influenza immunization, routine physical examination, and dental visit. Self-care included maintaining normal weight, not smoking, and engagement in recommended vigorous physical activity. We conducted unadjusted and adjusted logistic regression analyses to examine the change in engagement in health promoting activities over time. We found rates of annual influenza immunization (66.8% vs 70.3%), dental visit (71.8% vs 70.3%), and normal weight (33.9% vs 33.5%) did not change from 2006 to 2015. The percent with physical examination (90.8% vs 93.8%; P = .03) and non-smokers increased (87.9% vs 91.2; P = .04). Between 2006 and 2015, despite guidelines and recommendations for personalized cancer survivorship health plans, health promoting activities among cancer survivors did not change significantly.

The Misuse and Abuse of Prescription Medications: Medical Regulation, Prevention and Care Initiatives in New Jersey

2014 ◽  
Vol 100 (3) ◽  
pp. 7-18
Author(s):  
Sindy M. Paul ◽  
Virginia Allread
Keyword(s):  
United States ◽  
New Jersey ◽  
Opioid Analgesics ◽  
The United States ◽  
Heroin Addiction ◽  
Prescription Drug Abuse ◽  
Drug Problem ◽  
Prescribing Practices ◽  
Medical Regulation ◽  
State Medical Boards

ABSTRACT Prescription drug abuse is considered the fastest growing drug problem in the United States. The major increase is in unintentional drug overdose from opioid analgesics, which has caused more overdose-related deaths since 2003 than cocaine and heroin combined. The misuse of prescription pills is becoming particularly prevalent among suburban and rural youth in the United States, sometimes leading to heroin addiction and putting this population at a higher risk of blood-borne pathogens where heroin is injected. New Jersey has spearheaded initiatives to address misuse of opioid analgesics. These initiatives, which are part of an overall strategy and include medical regulatory response, are consistent with the newly (2013) updated Federation of State Medical Boards (FSMB) guidelines to better educate physicians and aid in the proper diagnosis and treatment of pain. They address physician prescribing practices, consumer need for safe disposal and treatment, and educational campaigns that target providers and the general public.

scholarly journals Geographic and temporal variation in racial and ethnic disparities in SARS-CoV-2 positivity between February 2020 and August 2021 in the United States

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Jacqueline M. Ferguson ◽  
Amy C. Justice ◽  
Thomas F. Osborne ◽  
Hoda S. Abdel Magid ◽  
Amanda L. Purnell ◽  
...  
Keyword(s):  
United States ◽  
Ethnic Disparities ◽  
Personal Characteristics ◽  
The United States ◽  
Racial And Ethnic Disparities ◽  
Department Of Veterans Affairs ◽  
Electronic Health Record Data ◽  
Time Period ◽  
Wide Range ◽  
Over Time

AbstractThe coronavirus pandemic has disproportionally impacted racial and ethnic minority communities in the United States. Patterns of these disparities may be changing over time as outbreaks occur in different communities. Utilizing electronic health record data from the US Department of Veterans Affairs (VA), we estimated odds ratios, stratified by time period and region, for testing positive among 1,313,402 individuals tested for SARS-CoV-2 between February 12, 2020 and August 16, 2021 at VA medical facilities. We adjusted for personal characteristics (sex, age, rural/urban residence, VA facility) and a wide range of clinical characteristics that have been evaluated in prior SARS-CoV-2 reports and could potentially explain racial/ethnic disparities in SARS-CoV-2. Our study found racial and ethnic disparities for testing positive were most pronounced at the beginning of the pandemic and decreased over time. A key finding was that the disparity among Hispanic individuals attenuated but remained elevated, while disparities among Asian individuals reversed by March 1, 2021. The variation in racial and ethnic disparities in SARS-CoV-2 positivity by time and region, independent of underlying health status and other demographic characteristics in a nationwide cohort, provides important insight for strategies to prevent further outbreaks.

scholarly journals New Opioid Analgesic Approvals and Outpatient Utilization of Opioid Analgesics in the United States, 1997 through 2015

2018 ◽  
Vol 128 (5) ◽  
pp. 953-966 ◽  
Author(s):  
Grace Chai ◽  
Jing Xu ◽  
James Osterhout ◽  
Mark A. Liberatore ◽  
Kathleen L. Miller ◽  
...  
Keyword(s):  
United States ◽  
Opioid Analgesic ◽  
Opioid Analgesics ◽  
The United States ◽  
New Drugs ◽  
Prescribing Patterns ◽  
Silver Spring ◽  
Primary Driver ◽  
Retail Setting ◽  
The U.S

Abstract Background The opioid epidemic, driven in part by increased prescribing, is a public health emergency. This study examines dispensed prescription patterns and approvals of new opioid analgesic products to investigate whether the introduction of these new drugs increases prescribing. Methods Prescribing patterns based on dispensed prescription claims from the U.S. retail setting were assessed with new brand and generic opioid analgesic products approved in the United States from 1997 through 2015. Results From 1997 through 2015, the U.S. Food and Drug Administration (Silver Spring, Maryland) approved 263 opioid analgesic products, including 33 brand products. Dispensed prescriptions initially increased 80% from 145 million prescriptions in 1997 to a peak of 260 million prescriptions in 2012 before decreasing by 12% to 228 million prescriptions in 2015. Morphine milligram equivalents dispensed per prescription increased from 486 in 1997 to a peak of 950 in 2010, before decreasing to 905 in 2015. In 2015, generic products accounted for 96% (218/228 million prescriptions) of all opioid analgesic prescriptions dispensed. The remaining prescriptions were dispensed for brand products, of which nearly half were dispensed for one brand product (OxyContin, Purdue, USA). Conclusions There has been a dramatic increase in prescriptions dispensed for opioid analgesics since 1997 and an increasing number of opioid analgesic approvals; however, the number of prescriptions dispensed has declined since 2012 despite an increasing number of approvals. Examination of dispensed prescriptions shows a shifting and complex market where multiple factors likely influence prescribing; the approval of new products alone may not be sufficient to be a primary driver of increased prescribing.

An Analysis of Fraudulent Qui Tam Actions Over Time in the United States

2007 ◽  
Author(s):  
Karen A. Fitzner ◽  
Charlie Bennett ◽  
June McKoy ◽  
Cara Tigue
Keyword(s):  
United States ◽  
The United States ◽  
Over Time

The New Economic Populism and the Future of Inequality in the United States

2017 ◽  
Author(s):  
William W. Franko ◽  
Christopher Witko
Keyword(s):  
United States ◽  
Federal Government ◽  
Labor Unions ◽  
Republican Party ◽  
The United States ◽  
The Public ◽  
Empirical Results ◽  
Income Disparities ◽  
The Face ◽  
Over Time

The authors conclude the book by recapping their arguments and empirical results, and discussing the possibilities for the “new economic populism” to promote egalitarian economic outcomes in the face of continuing gridlock and the dominance of Washington, DC’s policymaking institutions by business and the wealthy, and a conservative Republican Party. Many states are actually addressing inequality now, and these policies are working. Admittedly, many states also continue to embrace the policies that have contributed to growing inequality, such as tax cuts for the wealthy or attempting to weaken labor unions. But as the public grows more concerned about inequality, the authors argue, policies that help to address these income disparities will become more popular, and policies that exacerbate inequality will become less so. Over time, if history is a guide, more egalitarian policies will spread across the states, and ultimately to the federal government.

scholarly journals SAT0172 UTILIZATION OF HYDROXYCHLOROQUINE AND CORTICOSTEROIDS AMONG LUPUS PATIENTS WITH INCIDENT END-STAGE RENAL DISEASE (ESRD) ONSET: A LONGITUDINAL STUDY USING USRDS REGISTRY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1027.2-1027
Author(s):  
A. R. Broder ◽  
W. Mowrey ◽  
A. Valle ◽  
B. Goilav ◽  
K. Yoshida ◽  
...  
Keyword(s):  
United States ◽  
Lupus Nephritis ◽  
Renal Disease ◽  
International Classification Of Diseases ◽  
The United States ◽  
Diagnostic Code ◽  
Prescribing Practices ◽  
Part D ◽  
Stage Renal Disease

Background:The development of ESRD due to lupus nephritis is one of the most common and serious complications of SLE. Mortality among SLE ESRD patients is 4-fold higher compared to lupus nephritis patients with preserved renal function1Mortality in SLE ESRD is also twice as high compared with non-SLE ESRD, even though SLE patients develop ESRD at a significantly younger age. In the absence of ESRD specific guidelines, medication utilization in SLE ESRD is unknown.Objectives:The objective of this study was to investigate the real-world current US-wide patterns of medication prescribing among lupus nephritis patients with new onset ESRD enrolled in the United States Renal Disease Systems (USRDS) registry. We specifically focused on HCQ and corticosteroids (CS) as the most used medications to treat SLE.Methods:Inclusion: USRDS patients 18 years and above with SLE as a primary cause of ESRD (International Classification of Diseases, 9thRevision (ICD9) diagnostic code 710.0, previously validated2). who developed ESRD between January 1st, 2006 and July 31, 2011 (to ensure at least 6 months of follow-up in the USRDS). Patients had to be enrolled in Medicare Part D (to capture pharmacy claims). The last follow-up date was defined as either the last date of continuous part D coverage or the end of the study period, Dec 31, 2013.Results:Of the 2579 patients included, 1708 (66%) were HCQ- at baseline, and 871 (34%) were HCQ+ at baseline. HCQ+ patients at baseline had a slightly lower duration of follow-up compared to HCQ- patients at baseline, median (IQR) of 2.32 (1.33, 3.97) years and 2.55 (1.44, 4.25) years, respectively, p= 0.02. During follow-up period, only 778 (30%) continued HCQ either intermittently or continuously to the last follow-up date, 1306 (51%) were never prescribed HCQ after baseline, and 495 (19%) discontinued HCQ before the last follow-up date. Of the 1801 patients who were either never prescribed or discontinued HCQ early after ESRD onset, 713 (40%) were prescribed CS to the end of the follow-up period: 55% were receiving a low dose <10mg/daily, and 43 were receiving moderate dose (10-20mg daily)Conclusion:HCQ may be underprescribed and CS may be overprescribed in SLE ESRD. Changing the current prescribing practices may improve outcomes in SLE ESRDReferences:[1]Yap DY et al., NDT 2012.[2]Broder A et al., AC&R 2016.Acknowledgments :The data reported here have been supplied by the United States Renal Data System (USRDS). The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy or interpretation of the U.S. government.Funding: :NIH/NIAMS K23 AR068441 (A Broder), NIH/NIAMS R01 AR 057327 and K24 AR 066109 (KH Costenbader)Disclosure of Interests: :Anna R. Broder: None declared, Wenzhu Mowrey: None declared, Anna Valle: None declared, Beatrice Goilav: None declared, Kazuki Yoshida: None declared, Karen Costenbader Grant/research support from: Merck, Consultant of: Astra-Zeneca

scholarly journals Thirty-Day Laboratory-Based Surveillance for Carbapenem-Resistant Enterobacteriaceae in the Minneapolis-St. Paul Metropolitan Area

2014 ◽  
Vol 35 (4) ◽  
pp. 423-425 ◽  
Author(s):  
Edwin C. Pereira ◽  
Kristin M. Shaw ◽  
Paula M. Snippes Vagnone ◽  
Jane E. Harper ◽  
Alexander J. Kallen ◽  
...  
Keyword(s):  
United States ◽  
Metropolitan Area ◽  
The United States ◽  
Carbapenem Resistant ◽  
Over Time ◽  
Carbapenem Resistant Enterobacteriaceae

Carbapenem-resistant Enterobacteriaceae (CRE) are a growing problem in the United States. We explored the feasibility of active laboratory-based surveillance of CRE in a metropolitan area not previously considered to be an area of CRE endemicity. We provide a framework to address CRE surveillance and to monitor changes in the incidence of CRE infection over time.

scholarly journals Revealing the spatial shifting pattern of COVID-19 pandemic in the United States

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Di Zhu ◽  
Xinyue Ye ◽  
Steven Manson
Keyword(s):  
United States ◽  
Long Range ◽  
Network Optimization ◽  
Network Modeling ◽  
The United States ◽  
Standard Series ◽  
Time And Space ◽  
Long Range Interactions ◽  
Dynamic Relationships ◽  
Over Time

AbstractWe describe the use of network modeling to capture the shifting spatiotemporal nature of the COVID-19 pandemic. The most common approach to tracking COVID-19 cases over time and space is to examine a series of maps that provide snapshots of the pandemic. A series of snapshots can convey the spatial nature of cases but often rely on subjective interpretation to assess how the pandemic is shifting in severity through time and space. We present a novel application of network optimization to a standard series of snapshots to better reveal how the spatial centres of the pandemic shifted spatially over time in the mainland United States under a mix of interventions. We find a global spatial shifting pattern with stable pandemic centres and both local and long-range interactions. Metrics derived from the daily nature of spatial shifts are introduced to help evaluate the pandemic situation at regional scales. We also highlight the value of reviewing pandemics through local spatial shifts to uncover dynamic relationships among and within regions, such as spillover and concentration among states. This new way of examining the COVID-19 pandemic in terms of network-based spatial shifts offers new story lines in understanding how the pandemic spread in geography.

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