geoffrey modest medical blogs

A few recent articles highlighted the continuing problem in the US with opioid prescriptions. This blog will deal with a study showing much higher prescribing of opioids overall by dentists in the US vs England, and much stronger ones at that (see   opioid scripts by dentists jamaintmed2018  in dropbox, or  doi:10.1001/jamanetworkopen.2019.4303 ). another blog tomorrow.... Details: -- cross-sectional study of prescriptions for opioids dispensed from outpatient pharmacies in healthcare settings in 2016, by dentists in the US and England     -- the US data source was the IQVIA LRx database, which captures 85% of all outpatient prescriptions, including people commercially insured, Medicare, Medicaid, and cash payment (but not the VA)     -- the English data are from the NHS Digital Prescription Cost Analysis database, but were only available for England and not the whole UK Results: -- US dentist...

A recent large-scale data-mining study found that dental clinicians prescribed lots of opioids to US adolescents and young adults, with a substantial subsequent risk of opioid use and abuse (see  opioid scripts by dentists jamaintmed2018 in dropbox, or doi:10.1001/jamainternmed.2018.5419). Details: -- retrospective cohort study of outpatient opioid prescriptions for patients aged 16 to 25, with continuous enrollment in the Optum Research Database in 2015 (which contains de-identified inpatient, outpatient, and pharmacy claims data for 12 to 14 million privately insured US patients per year across the 50 states), matched with clinician NPI numbers -- 97,462 (13%) of the 754,002 individuals 16-25 yo with received one or more opioid prescriptions     -- 29,791 (31%) received prescriptions by a dental clinician     -- 14,888 opioid-exposed patients were enrolled, after excluding those with a record of prior opioid prescrip...