Dentists' prescribing of antibiotics and opioids to Medicare Part D beneficiaries Medications of high impact to public health
Dentists' prescribing of antibiotics and opioids to Medicare Part D beneficiaries Medications of high impact to public health
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DOI：
10.1016/j.adaj.2018.04.027
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发表时间：
2018-08-01
影响因子：
3.9
通讯作者：
Evans, Charlesnika T.
中科院分区：
文献类型：
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作者：
Koppen, Laura;Suda, Katie J.;Evans, Charlesnika T.
背景更好地了解牙科处方可以帮助确定有关最佳药物使用的干预机会。本研究的目的是在美国的医疗保险D部分处方药的特点阿片类药物和抗生素处方模式。作者对2014年国家医疗保险D部分处方者公共使用文件数据进行了回顾性横断面分析。包括数据集中与牙科相关学科的提供者（n = 99，797）。结果的兴趣是平均天数的供应和平均索赔报告每索赔，受益人和处方学科。在提交的6，724，372份牙科处方索赔中，分别有3，947，848份（58.7%）和1，312，796份（19.5%）是抗生素和阿片类药物。阿片类药物处方者中最高四分位数的69%的牙医也是抗生素处方者中最高四分位数的牙医（r（2）= 0.7778; P <0.01）。每项索赔的平均（标准差）供应天数为抗生素6.9（5.3）天（范围1-90天），类阿片3.6（2.0）天（范围1-44.5天）。在33，348名处方阿片类药物的牙科医生中，有18，971名（56.9%）处方的平均阿片类药物日数大于急性疼痛的推荐持续时间3天。阿片类药物和抗生素是牙医最常用的药物。根据国家建议和其他国家的研究结果，规定的治疗时间可能过长。应进行进一步的研究，以评估牙科处方的适当性。抗生素和阿片类药物管理干预措施应沿着药物考虑牙科。
Background. Gaining a better understanding of dental prescribing can help identify opportunities for intervention regarding optimal medication use. The purpose of this study is to characterize opioid and antibiotic prescribing patterns of dentists in the United States for Medicare Part D beneficiaries.Methods. The authors conducted a retrospective cross-sectional analysis of national 2014 Medicare Part D Prescriber Public Use File data. Providers in the data set with dental-related disciplines were included (n = 99,797). Outcomes of interest were mean days' supply and mean number of claims reported per claim, beneficiary, and prescriber discipline.Results. Of the 6,724,372 dental prescription claims submitted, 3,947,848 (58.7%) and 1,312,796 (19.5%) were for antibiotics and opioids, respectively. Sixty-nine percent of dentists in the highest quartile of opioid prescribers were also in the highest quartile of antibiotic prescribers (r(2) = 0.7778; P < .01). The mean (standard deviation) days' supply per claim was 6.9 (5.3) days (range, 1-90 days) for antibiotics and 3.6 (2.0) days (range, 1-44.5 days) for opioids. Of the 33,348 dental providers who prescribed opioids, 18,971 (56.9%) prescribed a mean opioid days per claim greater than the recommended duration of 3 days for acute pain.Conclusion. Opioids and antibiotics are the medications most prescribed by dentists. On the basis of national recommendations and results of studies from other countries, the length of therapy prescribed may be excessive. Further studies should be conducted to assess appropriateness of dental prescriptions.Practical Implications. Dentistry should be considered for antibiotic and opioid stewardship interventions along with medicine.