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dc.contributor.authorHunnicutt, Jacob N.
dc.contributor.authorHume, Anne L.
dc.contributor.authorUlbricht, Christine M.
dc.contributor.authorTjia, Jennifer
dc.contributor.authorLapane, Kate L.
dc.date2022-08-11T08:10:35.000
dc.date.accessioned2022-08-23T17:13:31Z
dc.date.available2022-08-23T17:13:31Z
dc.date.issued2018-06-04
dc.date.submitted2018-08-16
dc.identifier.citation<p>Pharmacoepidemiol Drug Saf. 2018 Jun 4. doi: 10.1002/pds.4568. [Epub ahead of print] <a href="https://doi.org/10.1002/pds.4568">Link to article on publisher's site</a></p>
dc.identifier.issn1053-8569 (Linking)
dc.identifier.doi10.1002/pds.4568
dc.identifier.pmid29869441
dc.identifier.urihttp://hdl.handle.net/20.500.14038/46745
dc.description.abstractPURPOSE: To estimate the proportion of residents newly initiating long-acting opioids in comparison to residents initiating short-acting opioids and examine variation in long-acting opioid initiation by region and resident characteristics. METHODS: This cross-sectional study included 182 735 long-stay nursing home residents in 13 881 US nursing homes who were Medicare beneficiaries during 2011 to 2013 and initiated a short-acting or long-acting opioid (excluding residents < 50 years old, those with cancer, or receiving hospice care). Medicare Part D prescription claims were used to identify residents as newly initiating short-acting or long-acting opioids, defined as having a prescription claim for an opioid with no prior opioid prescriptions in the preceding 60 days. We estimated the overall proportion of initiators prescribed long-acting opioids. Regional variation was examined by mapping results by state and hospital referral regions. Logistic models were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). RESULTS: Two percent of opioid initiators were prescribed long-acting opioids. State variation in long-acting opioid initiation ranged from 0.6% to 7.5% (5th-95th percentiles: 0.6-6.4%). Resident characteristics associated with increased long-acting opioid initiation included severe physical limitations (vs none/mild limitations; aOR: 2.13, 95% CI: 1.92-2.37) and pain (staff-assessed vs no pain; aOR: 1.59 95% CI: 1.40-1.80), whereas being non-White was inversely associated (non-Hispanic black vs non-Hispanic white; aOR: 0.70, 95% CI: 0.62-0.79). CONCLUSION: United States nursing home residents predominantly initiate short-acting opioids in accordance with Center for Disease Control and Prevention guidelines. Documented variation by geographic and resident characteristics suggests that improvements are possible.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=29869441&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://doi.org/10.1002/pds.4568
dc.subjectlong-acting opioids
dc.subjectlong-term care
dc.subjectnursing homes
dc.subjectpharmacoepidemiology
dc.subjectprescription opioids
dc.subjectEpidemiology
dc.subjectGeriatrics
dc.subjectHealth Services Administration
dc.subjectHealth Services Research
dc.subjectMedical Pharmacology
dc.subjectPharmaceutical Preparations
dc.subjectPharmacy and Pharmaceutical Sciences
dc.subjectTherapeutics
dc.titleLong-acting opioid initiation in US nursing homes
dc.typeJournal Article
dc.source.journaltitlePharmacoepidemiology and drug safety
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/1205
dc.identifier.contextkey12670999
html.description.abstract<p>PURPOSE: To estimate the proportion of residents newly initiating long-acting opioids in comparison to residents initiating short-acting opioids and examine variation in long-acting opioid initiation by region and resident characteristics.</p> <p>METHODS: This cross-sectional study included 182 735 long-stay nursing home residents in 13 881 US nursing homes who were Medicare beneficiaries during 2011 to 2013 and initiated a short-acting or long-acting opioid (excluding residents < 50 years old, those with cancer, or receiving hospice care). Medicare Part D prescription claims were used to identify residents as newly initiating short-acting or long-acting opioids, defined as having a prescription claim for an opioid with no prior opioid prescriptions in the preceding 60 days. We estimated the overall proportion of initiators prescribed long-acting opioids. Regional variation was examined by mapping results by state and hospital referral regions. Logistic models were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).</p> <p>RESULTS: Two percent of opioid initiators were prescribed long-acting opioids. State variation in long-acting opioid initiation ranged from 0.6% to 7.5% (5th-95th percentiles: 0.6-6.4%). Resident characteristics associated with increased long-acting opioid initiation included severe physical limitations (vs none/mild limitations; aOR: 2.13, 95% CI: 1.92-2.37) and pain (staff-assessed vs no pain; aOR: 1.59 95% CI: 1.40-1.80), whereas being non-White was inversely associated (non-Hispanic black vs non-Hispanic white; aOR: 0.70, 95% CI: 0.62-0.79).</p> <p>CONCLUSION: United States nursing home residents predominantly initiate short-acting opioids in accordance with Center for Disease Control and Prevention guidelines. Documented variation by geographic and resident characteristics suggests that improvements are possible.</p>
dc.identifier.submissionpathqhs_pp/1205
dc.contributor.departmentDepartment of Quantitative Health Sciences


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