scholarly journals Trends in the number of patients linked to potential vet-shopping behavior in the United States (2014-2019)

2021 ◽  
pp. 1-6
Author(s):  
Kao-Ping Chua ◽  
Jeanmarie Perrone ◽  
Laurel E. Redding ◽  
Chad M. Brummett ◽  
Shreya Bahl ◽  
...  
Keyword(s):  
United States ◽  
Opioid Analgesics ◽  
The United States ◽  
Shopping Behavior ◽  
National Database ◽  
Annual Number ◽  
Controlled Substances ◽  
Medical Associations ◽  
Prescription Drug Monitoring Programs ◽  
Number Of Patients

Abstract OBJECTIVE To estimate the number of patients linked to vet-shopping behavior (the solicitation of controlled substance prescriptions from multiple veterinarians for misuse) in the United States using 2014–2019 data and characterize mandates for veterinarians to examine prescription drug monitoring programs (PDMPs) before prescribing controlled substances as of April 2021. SAMPLE National database reporting prescription dispensing from 92% of US pharmacies from 2014 through 2019. PROCEDURES The annual number of patients with dispensed prescriptions for opioid analgesics, opioid cough-and-cold medications, or benzodiazepines from ≥ 4 veterinarians was calculated. State veterinary medical associations were contacted for information on veterinarian PDMP use mandates. RESULTS From 2014 through 2019, the number of patients with prescriptions for any class of controlled substances from ≥ 4 veterinarians tripled from 935 to 2,875 (+207.5%). The number of patients with opioid cough-and-cold medication prescriptions from ≥ 4 veterinarians rose from 150 to 1,348 (+798.9%). The corresponding number for benzodiazepines rose from 185 to 440 (+137.8%). The corresponding number for opioid analgesics peaked at 868 in 2016 before decreasing to 733 in 2019. In April 2021, 10 states mandated veterinarians to examine PDMP records of owners or animals before prescribing controlled substances; 3 mandates excluded benzodiazepines. CLINICAL RELEVANCE Vet shopping in the US may be increasingly common. Mandates for veterinarians to examine PDMPs before prescribing controlled substances might facilitate detection of this behavior. However, benefits of mandates should be weighed against their potential burden on veterinarians.

scholarly journals Levothyroxine prescriptions trends may indicate a downtrend in prescribing

2020 ◽  
Vol 11 ◽  
pp. 204201882092055
Author(s):  
Jacqueline Jonklaas ◽  
Sameer DeSale
Keyword(s):  
United States ◽  
The United States ◽  
Thyroid Stimulating Hormone ◽  
Annual Number ◽  
Washington Dc ◽  
Time Period ◽  
Number Of Patients ◽  
Prescribing Trends ◽  
System Operating ◽  
Over Time

Background: There has been a trend for increased prescribing of levothyroxine (LT4) in many countries, including the United States. Several different factors have been suggested to be the cause of this practice pattern. These factors include increased size of the United States population, more diagnosis of hypothyroidism, more treatment of minimally elevated thyroid-stimulating hormone (TSH) levels, more use of LT4 in older patients, and use of LT4 for treatment of euthyroid patients with non-thyroidal conditions. Methods: The electronic databases of the MedStar Health system operating in the Washington, DC and Maryland areas were interrogated to determine the number of patients who were being prescribed levothyroxine during the time period 2008–2016, the number of prescriptions supplied to these individuals, the associated diagnosis, and whether the prescriptions were new or existing prescriptions. Regression analyses were also performed to determine the prescribing trends during this time period. Results: Although the annual number of levothyroxine prescriptions increased during this time period, the percentage of patients in the database receiving levothyroxine for hypothyroidism initially increased and then decreased over time (2.5% to 3.2% to 2.5%). The percentage of prescriptions written for patients who did not appear to carry a diagnosis of hypothyroidism steadily declined (3.5% to 1.0%). Although the percentage of patients with existing prescriptions for hypothyroidism initially increased and then were maintained at steady levels (1.4% to 2.4% to 2.2%), a smaller percentage of patients with existing prescriptions were documented over time when there was no diagnosis of hypothyroidism (1.45% to 0.89%). The percentage of patients with new prescriptions declined over time for all groups. The number of annual 90-day period prescriptions increased over the time for patients with a diagnosis of hypothyroidism, but down-trended starting over the latter part of the time period for those patients without a diagnosis of hypothyroidism. Conclusion: Taken together, these data suggest that there may be a stabilization, and even a down-trend in levothyroxine prescribing with the MedStar system. The decrease in levothyroxine prescribing appears to be accounted for by less use of levothyroxine without an established diagnosis of hypothyroidism, and less initiation of new prescriptions.

Mosquito and Tick-borne Illnesses in the United States. Guidelines for the Recognition and Empiric Treatment of Zoonotic Diseases in the Wilderness.

2019 ◽  
Vol 19 (3) ◽  
pp. 238-257
Author(s):  
Suresh Antony
Keyword(s):  
United States ◽  
Lyme Disease ◽  
Spotted Fever ◽  
Disease Process ◽  
Rocky Mountain ◽  
The United States ◽  
Health Care Facilities ◽  
Diagnostic Tools ◽  
Rocky Mountain Spotted Fever ◽  
Number Of Patients

Background:In the United States, tick-borne illnesses account for a significant number of patients that have been seen and treated by health care facilities. This in turn, has resulted in a significant morbidity and mortality and economic costs to the country.Methods:The distribution of these illnesses is geographically variable and is related to the climate as well. Many of these illnesses can be diagnosed and treated successfully, if recognized and started on appropriate antimicrobial therapy early in the disease process. Patient with illnesses such as Lyme disease, Wet Nile illness can result in chronic debilitating diseases if not recognized early and treated.Conclusion:This paper covers illnesses such as Lyme disease, West Nile illness, Rocky Mountain Spotted fever, Ehrlichia, Tularemia, typhus, mosquito borne illnesses such as enteroviruses, arboviruses as well as arthropod and rodent borne virus infections as well. It covers the epidemiology, clinical features and diagnostic tools needed to make the diagnosis and treat these patients as well.

scholarly journals THE EPIDEMIOLOGY OF PEDIATRIC MENISCAL ALLOGRAFT TRANSPLANTATION IN THE UNITED STATES

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0004
Author(s):  
Haley E. Smith ◽  
Madeline M. Lyons ◽  
Neeraj M. Patel
Keyword(s):  
United States ◽  
Pediatric Population ◽  
The United States ◽  
National Database ◽  
Control Group ◽  
Meniscal Allograft Transplantation ◽  
Children's Hospitals ◽  
Allograft Transplantation ◽  
Meniscal Allograft ◽  
Children’S Hospitals

Background: Meniscal allograft transplantation (MAT) is an option to slow the progression of degenerative disease in the setting of substantial meniscal deficiency. This may be especially important in children and adolescents, but there is little literature on MAT in this population. Hypothesis/Purpose: The purpose of this study was to evaluate the epidemiology of MAT in the pediatric population, with specific attention to regional and demographic trends. Methods: The Pediatric Health Information System, a national database consisting of 49 children’s hospitals, was queried for all patients undergoing MAT between 2011 and 2018. Demographic information was collected for each subject as well as data regarding previous and subsequent surgeries. The database was also queried for all meniscus surgeries (including repairs and meniscectomies) performed during the study period. Demographic and geographic data from this control group were compared to that of children undergoing MAT. Univariate analysis was followed by purposeful entry multivariate regression to adjust for confounding factors. Results: A total of 27,168 meniscus surgeries were performed in 47 hospitals, with MAT performed 67 times in 17 hospitals. Twelve patients (18%) underwent a subsequent procedure after transplantation. In multivariate analysis, each year of increasing age resulted in 1.1 times higher odds of having undergone MAT rather than repair or meniscectomy (95% CI 1.03-1.1, p=0.002). Patients that underwent transplantation had 2.0 times higher odds of being female (95% CI 1.2-3.3, p=0.01) and 2.0 times higher odds of being commercially insured (95% CI 1.1-3.6, p=0.02). MAT was performed most frequently in the Northeast (4.9/1000 meniscus surgeries) and least often in the South (1.1/1000 meniscus surgeries, p<0.001). Furthermore, transplantation was more likely to be performed in larger cities. The median pediatric population of cities in which MAT was performed was 983,268 (range 157,253-3,138,870) compared to 662,290 (range 4,420-4,311,500) in cities where it was not (p=0.04). Conclusion: In the United States, patients that underwent MAT were older, more likely to be female, and have commercial insurance than those undergoing meniscus repair or meniscectomy. MAT was only done in 17/47 children’s hospitals that perform meniscus surgery and was most frequently performed in the Northeast and in larger cities. These trends highlight the need for further research, especially regarding differences along the lines of sex and insurance status.

System-wide seismic vulnerability of aging multiple-span multiple-girder bridges in low-to-moderate seismic hazard regions

2021 ◽  
Vol 37 (1_suppl) ◽  
pp. 1626-1651
Author(s):  
John E Lens M.EERI ◽  
Mandar M Dewoolkar ◽  
Eric M Hernandez M.EERI
Keyword(s):  
United States ◽  
Seismic Hazard ◽  
Cross Sections ◽  
Seismic Vulnerability ◽  
Time History ◽  
The United States ◽  
National Database ◽  
Eastern United States ◽  
Girder Bridges ◽  
The Status

This article describes the approach, methods, and findings of a quantitative analysis of the seismic vulnerability in low-to-moderate seismic hazard regions of the Central and Eastern United States for system-wide assessment of typical multiple span bridges built in the 1950s through the 1960s. There is no national database on the status of seismic vulnerability of bridges, and thus no means to estimate the system-wide damage and retrofit costs for bridges. The study involved 380 nonlinear analyses using actual time-history records matched to four representative low-to-medium hazard target spectra corresponding with peak ground accelerations from approximately 0.06 to 0.3 g. Ground motions were obtained from soft and stiff site seismic classification locations and applied to models of four typical multiple-girder with concrete bent bridges. Multiple-girder bridges are the largest single category, comprising 55% of all multiple span bridges in the United States. Aging and deterioration effects were accounted for using reduced cross-sections representing fully spalled conditions and compared with pristine condition results. The research results indicate that there is an overall low likelihood of significant seismic damage to these typical bridges in such regions, with the caveat that certain bridge features such as more extensive deterioration, large skews, and varied bent heights require bridge-specific analysis. The analysis also excludes potential damage resulting from liquefaction, flow-spreading, or abutment slumping due to weak foundation or abutment soils.

scholarly journals EPIDEMIOLOGY OF PEDIATRIC CARTILAGE RESTORATION PROCEDURES IN THE UNITED STATES: INSURANCE AND GEOGRAPHY PLAY A ROLE

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0024
Author(s):  
Tyler B. Hall ◽  
Max J. Hyman ◽  
Neeraj M. Patel
Keyword(s):  
United States ◽  
Children And Adolescents ◽  
Statistical Significance ◽  
Private Insurance ◽  
Univariate Analysis ◽  
The United States ◽  
National Database ◽  
The West ◽  
Cartilage Restoration ◽  
Common Diagnosis

Background: A number of surgical options are available for sizeable articular cartilage lesions of the knee. These include osteochondral autograft (OAU) or allograft (OAL) transfer, or autologous chondrocyte implantation (ACI). In the pediatric population, there is little data on the patients undergoing these procedures or evidence to support one technique over another, which may lead to variation in preferred practice. Hypothesis/Purpose: The purpose of this study is to analyze the epidemiology of children and adolescents undergoing OAU, OAL, and ACI in the United States, with attention to variation along the lines of demographic and geographic factors. Methods: The Pediatric Health Information System, a national database consisting of 49 children’s hospitals, was queried for all patients undergoing OAU, OAL, and ACI between 2012 and 2018. Demographic information was collected for each subject. United States Census guidelines were used to categorize hospitals geographically into regions. Univariate analysis was followed by purposeful entry multivariate regression to adjust for confounding factors. Results: A total of 809 subjects with a mean age of 15.4±2.4 years were included in the analysis. Of these, 393 (48.6%) underwent OAL, 339 (41.9%) underwent OAU, and 77 (9.5%) underwent ACI. The most common diagnosis at the time of surgery was osteochondritis dissecans in 360 patients (44.5%) followed by an associated cruciate ligament injury in 126 (15.6%) and patellar instability in 98 (12.1%). After adjusting for confounders in a multivariate model, ACI was more 3.4 times more likely to be performed in patients with private insurance than those that were publicly insured (95% CI 1.5-7.5, p=0.002). Furthermore, a patient in this Northeast was 29.3 times more likely to undergo ACI than in the West (95% CI 4.0-217.4, p=0.001). OAU was performed most frequently in the West and Midwest (52.4% and 51.8% of the time, respectively; p<0.001). Univariate analysis also revealed differences along the lines of race, but these findings did not maintain statistical significance in multivariate analysis. Conclusion: In the United States, there is substantial variation in the procedures performed for cartilage restoration in children and adolescents. Though ACI is the least commonly selected operation overall, it is significantly more likely to be performed on patients with private insurance and those in the Northeast. OAU is the most commonly performed procedure in the West and Midwest.

scholarly journals Estimates of the Annual Number of Clinically Recognized Pregnancies in the United States, 1981-1991

1999 ◽  
Vol 149 (11) ◽  
pp. 1025-1029 ◽  
Author(s):  
M. Saraiya ◽  
C. J. Berg ◽  
H. Shulman ◽  
C. A. Green ◽  
H. K. Atrash
Keyword(s):  
United States ◽  
The United States ◽  
Annual Number

A Paradigm Shift in Healthcare Innovation as Revealed by Research Trends in Mobile Health: A Bibliometric Analysis. (Preprint)

2021 ◽  
Author(s):  
Jianfei Cao ◽  
Yeongjoo Lim ◽  
Shintaro Sengoku ◽  
Xitong Guo ◽  
Kota Kodama
Keyword(s):  
United States ◽  
Health Policy ◽  
Bibliometric Analysis ◽  
The United States ◽  
Research Trends ◽  
Annual Number ◽  
Public Healthcare ◽  
Growth Trend ◽  
Number Of Publications ◽  
Research Hotspots

BACKGROUND Smartphones have become an integral part of our lives with their unprecedented popularity and diversification of applications. The continuous upgrading of information technology has also enabled smartphones to display great potential in the field of healthcare. OBJECTIVE This study aimed to clarify the future research direction of mHealth by analyzing its research trends and latest research hotspots. METHODS This study collected mHealth-related literature published between 2000 and 2020 from the Web of Science database. Descriptive statistics of the literature were computed using Excel software. The publication trends of mHealth research were determined by analyzing the annual number of publications in the literature and annual number of publications categorized based on different countries. Finally, this study used the VOSviewer tool to construct visualization network maps of country/region collaborations and author keyword co-occurrences, and overlay visualization maps of the average publication year of author keywords to analyze the hotspots and research trends in mHealth research. RESULTS In this study, 12,593 mHealth-related research articles published between 2000 and 2020 were collected. The results showed an exponential growth trend in the number of annual publications in mHealth literature. The United States remained the leading contributor to the literature in this area (5,294/12,593, 42%), well ahead of other countries/regions. Other countries/regions also showed a clear trend of annual increases in the number of publications in mHealth literature. Regarding cooperation between countries, the four countries with the largest number of publications, the United States, the United Kingdom, Canada, and Australia, were found to cooperate more closely. The rest of the countries/regions showed a clear geographical pattern of cooperation. The keyword co-occurrence analysis of the top 100 authors formed five clusters, namely: development of mHealth medical technology and its application in various diseases, use of mHealth technology to improve basic public health and health policy, mHealth self-health testing and management in daily life, adolescent use of mHealth, and mHealth in mental health. The research trends revealed a gradual shift in mHealth research from health policy and improving public healthcare to the development and social application of mHealth technologies. CONCLUSIONS To the best of our knowledge, the most current bibliometric analysis dates back to 2016. However, the number of mHealth researches published between 2017 and 2020 exceeds the previous total. Therefore, the results of this study shed light on the latest research hotspots and research trends in mHealth research. These findings provide a useful overview of the development of the field; they may also serve as a valuable reference and provide guidance for other researchers in the field.

scholarly journals Trends Analysis of rhBMP2 Utilization in Single-Level Anterior Lumbar Interbody Fusion in the United States

2017 ◽  
Vol 8 (2) ◽  
pp. 137-141 ◽  
Author(s):  
Lifeng Lao ◽  
Jeremiah R. Cohen ◽  
Zorica Buser ◽  
Darrel S. Brodke ◽  
S. Tim Yoon ◽  
...  
Keyword(s):  
United States ◽  
Interbody Fusion ◽  
Average Rate ◽  
The United States ◽  
Anterior Lumbar Interbody Fusion ◽  
Bone Morphogenetic Protein 2 ◽  
National Database ◽  
Lumbar Interbody Fusion ◽  
Retrospective Case ◽  
Single Level

Study Design: Retrospective case study. Objective: To evaluate the trends and demographics of recombinant human bone morphogenetic protein 2 (rhBMP2) utilization in single-level anterior lumbar interbody fusion (ALIF) in the United States. Methods: Patients who underwent single-level ALIF from 2005 to 2011 were identified by searching ICD-9 diagnosis and procedure codes in the PearlDiver Patient Records Database (PearlDiver Technologies, Fort Wayne, IN), a national database of orthopedic insurance records. The year of procedure, age, gender, and region of the United States were analyzed for each patient. Results: A total of 921 patients were identified who underwent a single-level ALIF in this study. The average rate of single-level ALIF with rhBMP2 utilization increased (35%-48%) from 2005 to 2009, but sharply decreased to 16.7% in 2010 and 15.0% in 2011. The overall incidence of single-level ALIF without rhBMP2 (0.20 cases per 100 000 patients) was more than twice of the incidence of single-level ALIF with rhBMP2 (0.09 cases per 100 000 patients). The average rate of single-level ALIF with rhBMP2 utilization is highest in West (41.4%), followed by Midwest (33.3%), South (26.5%) and Northeast (22.2%). The highest incidence of single-level ALIF with rhBMP2 was observed in the group aged less than 65 years (compared with any other age groups, P < .001), with an incidence of 0.21 per 100 000 patients. Conclusions: The incidence of rhBMP2 utilization in single-level ALIF increased from 2006 to 2009, but decreased in 2010 and 2011. The Northeast region had the lowest incidence of rhBMP2 utilization. The group aged less than 65 years trended to have the higher incidence of single-level ALIF with rhBMP2 utilization.

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