Pattern, Variation and Outcomes of Opioid Prescription in Older Adults
老年人阿片类药物处方的模式、变化和结果
基本信息
- 批准号:9348599
- 负责人:
- 金额:$ 34.88万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2016
- 资助国家:美国
- 起止时间:2016-09-15 至 2020-06-30
- 项目状态:已结题
- 来源:
- 关键词:AcuteAddressAffectAgeAlabamaAlaskaBenzodiazepinesCessation of lifeChronicChronic low back painClassificationClinicalClinical Practice GuidelineCodeineComorbidityConfusionDataDegenerative polyarthritisDevelopmentDoseEffectivenessElderlyEmergency department visitEnsureEpidemicEquilibriumExposure toFormulationFoundationsFractureGuidelinesHigh PrevalenceHospitalizationHydrocodoneInstitutionalizationInterventionInvestigationKidney CalculiKnowledgeLeadMalignant NeoplasmsMedicalMedicareMedicare claimMorbidity - disease rateNew JerseyOperative Surgical ProceduresOpiate AddictionOpioidOpioid AnalgesicsOutcomeOutpatientsPainPain managementPatientsPatternPharmaceutical PreparationsPharmacistsPoliciesPopulationPrevalencePrimary Care PhysicianProviderPublic HealthPublic PolicyRegulationReportingResearch DesignRetrospective cohort studyRiskSafetyScheduleSelection BiasTexasToxic effectTramadolVariantaddictionadverse outcomeage relatedagedbeneficiarycancer diagnosisclinical practicecohortdrug metabolismexperiencefallsfederal policyinsightinterestlongitudinal analysismortalitymultilevel analysisnon-cancer painolder patientopioid useprescription opioidprogramspublic health relevanceresponse
项目摘要
DESCRIPTION (provided by applicant): Concerns have been raised about the safety and effectiveness of opioid analgesics for chronic non-cancer pain in view of a threefold increase in opioid prescribing and a dramatic increase in the rates of opioid-related adverse outcomes. Our preliminary data showed the rate of opioid prescriptions for older adults varied dramatically across states, from 2.7% in Texas to 14.5% in Alaska for schedule II and from 11.7% in New Jersey to 34.8% in Alabama for schedule III. We also found exceedingly high variability in prescribing schedule II/III opioids among primary care physicians (PCPs); the percentage of PCPs prescribing opioids to their non-cancer patients ranged from 0.4% to 70.5%. Twenty-three percent of the variance in whether an elderly patient received an opioid was explained by which PCP the patient saw. Such high variation in opioid prescribing-even after adjustment for patient mix-offers critical insight into the complexity and confusion surrounding this issue. On any given day, providers-faced with difficult decisions about treating patients with severe pain-must carefully balance the risks of overtreatment versus undertreatment. To date, no nationally representative studies have examined variations in the use of opioids in older adults and their relationship to outcomes, different state regulations, and federal policy. Our Specific Aims are: 1. Examine temporal changes in the prevalence, duration, and dose of opioid use in older adults, with particular focus on the impact of policy changes. 2. Assess the variation of opioid use across providers and determine patient and provider factors associated with opioid use in older adults. 3. Examine the risk of adverse outcomes-including falls, fractures, emergency room (ER) visits, hospitalization, institutionalization, and mortality-in older patients receiving opioids. We will use 2007-2015 100% national data on Medicare beneficiaries to investigate this escalating public health crisis. The proposed investigation will provide data that
can lead to improvements in public policy and clinical practice guidelines for ensuring safe and effective use of opioids in older adults.
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Yong-Fang Kuo其他文献
Yong-Fang Kuo的其他文献
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{{ truncateString('Yong-Fang Kuo', 18)}}的其他基金
Annual wellness visit policy: Impact on disparities in early dementia diagnosis and quality of healthcare for Medicare beneficiaries with Alzheimer's Disease and Its Related Dementias
年度健康就诊政策:对患有阿尔茨海默病及其相关痴呆症的医疗保险受益人的早期痴呆诊断和医疗质量差异的影响
- 批准号:
10729272 - 财政年份:2023
- 资助金额:
$ 34.88万 - 项目类别:
Academic Leadership Award in Data Science and Discovery
数据科学与发现学术领导奖
- 批准号:
9976726 - 财政年份:2020
- 资助金额:
$ 34.88万 - 项目类别:
UTMB Health Services Research Training Program
UTMB 健康服务研究培训计划
- 批准号:
10404039 - 财政年份:2018
- 资助金额:
$ 34.88万 - 项目类别:
The Texas Resource Center on Minority Aging Research (RCMAR)
德克萨斯州少数族裔老龄化研究资源中心 (RCMAR)
- 批准号:
10730105 - 财政年份:2018
- 资助金额:
$ 34.88万 - 项目类别:
UTMB Health Services Research Training Program
UTMB 健康服务研究培训计划
- 批准号:
10186800 - 财政年份:2018
- 资助金额:
$ 34.88万 - 项目类别:
UTMB Health Services Research Training Program
UTMB 健康服务研究培训计划
- 批准号:
10864285 - 财政年份:2018
- 资助金额:
$ 34.88万 - 项目类别:
Patterns and variation of opioid use in long-stay nursing home residents with dementia
患有痴呆症的长期入住疗养院居民的阿片类药物使用模式和变化
- 批准号:
9719244 - 财政年份:2016
- 资助金额:
$ 34.88万 - 项目类别:
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