Outpatient Prescribing of Antibiotics and Opioids by Veterans Health Administration Providers, 2015-2017.
Outpatient Prescribing of Antibiotics and Opioids by Veterans Health Administration Providers, 2015-2017.
复制标题
退伍军人卫生管理提供商对抗生素和阿片类药物的门诊处方，2015- 2017年。
DOI：
10.1016/j.amepre.2021.05.009
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发表时间：
2021-11
影响因子：
5.5
通讯作者：
Suda KJ
中科院分区：
文献类型：
--
作者：
Evans CT;Fitzpatrick MA;Poggensee L;Gonzalez B;Gibson G;Jurasic MM;Echevarria K;McGregor JC;Cunningham F;Gellad WF;Suda KJ
Antibiotics and opioids are targeted by public health and stewardship communities for reductions in prescribing across the country. This study evaluates trends and factors associated with outpatient prescribing by dental and medical providers in a large integrated health system. This was a cross-sectional study of national dental and medical outpatient visits from Department of Veterans Affairs facilities in 2015–2017; analyzed in 2019–2020. Antibiotic and opioid prescribing rates were assessed by provider and facility characteristics. Multivariable Poisson regression adjusted for repeated measures by provider was used to assess the independent association between facility and provider characteristics and rate of prescribing. Over the study period, 4,625,840 antibiotic and 10,380,809 opioid prescriptions were identified for 115,625,890 visits. Physicians prescribed most antibiotics (67%). Dentists prescribed 6% of antibiotics but had the highest per-visit antibiotic prescribing rate, compared with medical providers (6.75 vs 3.90 prescriptions/100 visits, p<0.0001), which was largely driven by dental specialists. By contrast, dentists had lower opioid prescribing than medical providers (3.02 vs 9.20 prescriptions/100 visits, p<0.0001). Overall, antibiotic and opioid prescribing decreased over time, with opioids having the greatest decreases (–28.0%). In multivariable analyses, U.S. geographic region, rurality, and complexity were associated with prescribing for both drug classes. Opioid and antibiotic prescribing were positively correlated. Though antibiotic and opioid prescribing has decreased, there are still important target areas for improvement. Interventions need to be tailored to community characteristics such as rurality and provider type.
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影响因子：
4.5
作者：
Kelly, Allison A.;Jones, Makoto M.;Roselle, Gary A.
通讯作者：
Roselle, Gary A.
影响因子：
5.5
作者：
Hubbard, Colin C.;Evans, Charlesnika T.;Suda, Katie J.
通讯作者：
Suda, Katie J.
影响因子：
4.5
作者：
Carlsen DB;Durkin MJ;Gibson G;Jurasic MM;Patel U;Poggensee L;Fitzpatrick MA;Echevarria K;McGregor J;Evans CT;Suda KJ
通讯作者：
Suda KJ
影响因子：
120.7
作者：
Fleming-Dutra, Katherine E.;Hersh, Adam L.;Hicks, Lauri A.
通讯作者：
Hicks, Lauri A.
影响因子：
33.7
作者：
Sanchez, Guillermo V.;Fleming-Dutra, Katherine E.;Hicks, Lauri A.
通讯作者：
Hicks, Lauri A.