| Title: |
High prescribing of antibiotics is associated with high prescribing of opioids in medical and dental providers |
| Authors: |
Evans, Charlesnika T.; Fitzpatrick, Margaret A.; Poggensee, Linda; Gonzalez, Beverly; Gibson, Gretchen; Jurasic, M. Marianne; Echevarria, Kelly; McGregor, Jessina C.; Gellad, Walid F.; Suda, Katie J. |
| Contributors: |
U.S. Department of Veterans Affairs |
| Source: |
Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy ; volume 42, issue 9, page 716-723 ; ISSN 0277-0008 1875-9114 |
| Publisher Information: |
Wiley |
| Publication Year: |
2022 |
| Collection: |
Wiley Online Library (Open Access Articles via Crossref) |
| Description: |
Study Objective High prescribers of antibiotics and opioids are an important target for stewardship interventions. The goal of this study was to assess the association between high antibiotic and high opioid prescribing by provider type. Design A national cross‐sectional study. Setting 2015–2017 Department of Veterans Affairs (VA) electronic health record data. Population Prescribers were identified as dentists (2017: n = 1346) and medical providers (physicians n = 23,072; advanced practice providers [APP] n = 7705; and other providers [pharmacists/chiropractors] n = 3674) (2017: n = 34,451). Measurements High prescribing was defined as being in the top 25% of visit‐based rates of antibiotic or opioid prescribing (number of prescriptions/number of dental or medical visits). Multivariable random effects logistic regression with clustering by facility was used to assess the adjusted association between high antibiotic and opioid prescribing. Results Medical providers prescribed 4,348,670 antibiotic and 10,256,706 opioid prescriptions; dentists prescribed 277,170 antibiotic and 124,103 opioid prescriptions. Among all high prescribers of antibiotics, 40% were also high prescribers of opioids as compared to 18% of those who were not high antibiotic prescribers ( p < 0.0001). High prescribing of antibiotics was associated with high prescribing of opioids in medical providers (adjusted odds ratio [aOR] = 2.87, 95% confidence interval [CI] = 2.72–3.04) and dentists (aOR = 8.40, 95% CI 6.00–11.76). Older provider age, specific US geographic regions, and lower VA facility complexity and rurality were also associated with high opioid prescribing by medical providers. In dentists, younger provider age, male gender, specific regions of the United States, and lower number of dentists in a facility were associated with high opioid prescribing. At the facility level, high dental prescribers of antibiotics or opioids were not at the same facilities as high medical prescribers, respectively ( p < 0.0001). ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1002/phar.2720 |
| Availability: |
https://doi.org/10.1002/phar.2720; https://onlinelibrary.wiley.com/doi/pdf/10.1002/phar.2720; https://onlinelibrary.wiley.com/doi/full-xml/10.1002/phar.2720 |
| Rights: |
http://onlinelibrary.wiley.com/termsAndConditions#vor |
| Accession Number: |
edsbas.359F0842 |
| Database: |
BASE |