Association Between State Opioid Prescribing Limits and Duration of Opioid Prescriptions From Dentists.
Association Between State Opioid Prescribing Limits and Duration of Opioid Prescriptions From Dentists.
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DOI：
10.1001/jamanetworkopen.2022.50409
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发表时间：
2023-01-03
影响因子：
13.8
通讯作者：
Brummett, Chad M.
中科院分区：
文献类型：
--
作者：
Chua, Kao-Ping;Nguyen, Thuy D.;Waljee, Jennifer F.;Nalliah, Romesh P.;Brummett, Chad M.
这项横断面研究评估了州政府具体实施阿片类药物处方是否与牙医为儿童和成人牙科患者开具阿片类药物处方的持续时间较短有关。国家阿片类药物处方限制是否与牙医阿片类药物处方持续时间的缩短有关？在这项横断面研究中，从2014年1月到2020年2月，美国有近9000万张阿片类药物处方分发给成人和儿童，这些处方的中位数持续时间为3.0天。实施国家阿片类药物处方限制，其中大多数允许最多7天的阿片类药物供应，与这些处方期限的变化无关。这项研究的结果表明，未来需要进行研究，评估替代干预措施在减少牙科阿片类药物处方方面的潜在作用。部分为了防止与牙科阿片类药物处方相关的危害，大多数州都制定了政策，限制急性疼痛的阿片类药物处方的持续时间。这些限制是否与牙医开出的阿片类药物处方的持续时间的变化有关尚不清楚。评估国家阿片类药物处方限制与牙医阿片类药物处方持续时间之间的关系。这项差异差异的横断面研究使用了来自IQVIA纵向处方数据库的数据，该数据库是一个所有付款人的数据库，报告了美国92%的零售药店的处方配药。样本包括2014年1月至2020年2月期间牙医给0至17岁的儿童和18岁或以上的成年人开的阿片类药物处方。治疗州是指在2016年1月至2018年12月期间实施限制的州。对照状态是指那些在研究期间没有实施限制的状态。有关阿片类药物处方限制的数据来自处方药滥用政策系统。对2022年1月1日至9月30日的数据进行了分析。国家阿片类药物处方限制。结果是阿片类药物处方的持续时间，以天数衡量。使用具有双向固定效应规范的线性模型来评估限制和持续时间之间的关联。协变量包括患者特征、处方特征和处方药监测计划使用要求的实施指标。由于治疗状态的数量和年龄限制的局限性的不同，对成人和儿童的数据进行了单独的分析。成人分析包括22个治疗状态和12个对照状态的34名 364名 775名患者的56张 607314阿片类药物处方(18名 448名 788名女性(53.7%)；最早填充时的平均[SD]年龄为44.0[17.4]岁)。儿童分析包括23个治疗状态和12个对照状态下3个 720个 837个阿片类药物处方，用于3个 165个 880个患者(1个 740个 449个女性(55.0%)；最早填充时的平均[SD]年龄14.4[3.5]岁)。在这两项分析中，阿片类药物处方的中位数(第25-75%)持续时间为3.0(2-5)天。限制的实施与成人(平均供应天数：−0.06天；95%CI，−0.11至0.001天)或儿童(平均供应天数：−0.07天；95%CI，−0.15至0.02天)的阿片类药物处方持续时间的变化无关。在这项对国家药房处方数据的研究中，阿片类药物处方限制与牙医阿片类药物处方持续时间的变化无关。未来的研究应该调查替代干预措施在减少牙医开阿片类药物处方方面的潜在作用。
This cross-sectional study assesses whether state-specific implementation of opioid prescribing is associated with a shorter duration of opioid prescriptions from dentists for children and adult dental patients. Are state opioid prescribing limits associated with reductions in the duration of opioid prescriptions from dentists? In this cross-sectional study of nearly 90 million dental opioid prescriptions dispensed to adults and children in the US from January 2014 through February 2020, the median duration of these prescriptions was 3.0 days. Implementation of state opioid prescribing limits, most of which allowed up to a 7-day supply of opioids, was not associated with changes in the duration of these prescriptions. The findings of this study suggest the need for future research evaluating the potential role of alternative interventions in reducing dental opioid prescribing. In part to prevent the harms associated with dental opioid prescriptions, most states have enacted policies limiting the duration of opioid prescriptions for acute pain. Whether these limits are associated with changes in the duration of opioid prescriptions written by dentists is unclear. To evaluate the association between state opioid prescribing limits and the duration of opioid prescriptions from dentists. This difference-in-differences cross-sectional study used data from the IQVIA Longitudinal Prescription Database, an all-payer database reporting prescription dispensing from 92% of retail pharmacies in the US. The sample included opioid prescriptions from dentists dispensed to children aged 0 to 17 years and adults 18 years or older from January 2014 through February 2020. Treatment states were those that implemented limits between January 2016 and December 2018. Control states were those that did not implement limits during the study period. Data on opioid prescribing limits were derived from the Prescription Drug Abuse Policy System. Data were analyzed from January 1 to September 30, 2022. State opioid prescribing limits. The outcome was opioid prescription duration, as measured by days’ supply. The association between limits and duration was evaluated using a linear model with a 2-way fixed-effects specification. Covariates included patient characteristics, prescription characteristics, and indicators of implementation of prescription drug monitoring program use mandates. Separate analyses of data from adults and children were conducted owing to differences in the number of treatment states and restrictiveness of limits by age. The adult analysis included 56 607 314 opioid prescriptions for 34 364 775 patients (18 448 788 females [53.7%]; mean [SD] age at the earliest fill, 44.0 [17.4] years) in 22 treatment states and 12 control states. The child analysis included 3 720 837 opioid prescriptions for 3 165 880 patients (1 740 449 females [55.0%]; mean [SD] age at the earliest fill, 14.4 [3.5] years) in 23 treatment states and 12 control states. In both analyses, the median (25th-75th percentile) duration of opioid prescriptions was 3.0 (2-5) days. Implementation of limits, most of which allowed up to a 7-day supply of opioids, was not associated with changes in the duration of opioid prescriptions for adults (mean days’ supply: −0.06 days; 95% CI, −0.11 to <0.001 days) or children (mean days’ supply: −0.07 days; 95% CI, −0.15 to 0.02 days). In this study of national pharmacy dispensing data, opioid prescribing limits were not associated with changes in the duration of opioid prescriptions from dentists. Future research should investigate the potential role of alternative interventions in reducing opioid prescribing by dentists.
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影响因子：
5.5
作者：
Chua KP;Kenney BC;Waljee JF;Brummett CM;Nalliah RP
通讯作者：
Nalliah RP
影响因子：
13.8
作者：
Chua KP;Hu HM;Waljee JF;Nalliah RP;Brummett CM
通讯作者：
Brummett CM
影响因子：
6
作者：
Davis, Corey S.;Lieberman, Amy Judd
通讯作者：
Lieberman, Amy Judd
影响因子：
6.3
作者：
Goodman-Bacon, Andrew
通讯作者：
Goodman-Bacon, Andrew
DOI：
10.1016/j.adaj.2021.01.001
发表时间：
2021-04
期刊：
Journal of the American Dental Association (1939)
影响因子：
--
作者：
Chua KP;Hu HM;Waljee JF;Brummett CM;Nalliah RP
通讯作者：
Nalliah RP