Introduction: In response to the role of opioid prescribing in the U.S. opioid crisis, states have enacted laws intended to curb high risk opioid prescribing practices. This study assessed the effects of state prescribing cap laws that limit the dose and/or duration of dispensed opioid prescriptions on opioid prescribing patterns and opioid overdose.
Methods: We identified 1,414,908 adults from a large U.S. administrative insurance claims database. Treatment states included 32 states that implemented a prescribing cap law between 2017 and 2019. Comparison states included 16 states and DC without a prescribing cap law by 2019. A difference-in-differences approach with staggered policy adoption was used to assess effects of these laws on opioid analgesic prescribing and opioid overdose.
Results: State opioid prescribing cap laws were not associated with changes in the proportion of people receiving opioid analgesic prescriptions, the dose or duration of opioid prescriptions, or opioid overdose. States with laws that imposed days' supply limits only versus days' supply and dosage limits, as well as with specific law provisions also showed no association with opioid prescribing or opioid overdose outcomes.
Conclusions: State opioid prescribing cap laws did not appear to impact outcomes related to opioid analgesic prescribing or opioid overdose. These findings are potentially due to the limited scope of these laws, which often apply only to a subset of opioid prescriptions and include professional judgment exemptions.
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http://dx.doi.org/10.1016/j.drugalcdep.2022.109626 | DOI Listing |
BMC Pediatr
December 2024
Department of pharmacy, College of Medicine and Health Sciences, Adigrat University, Tigrai, Ethiopia.
Background: Pneumonia is inflammation of the lung parenchyma and is a substantial cause of childhood morbidity and mortality in developing countries. Community-acquired pneumonia (CAP) is a type of pneumonia termed when patients who develop pneumonia in the outpatient setting and have not been in any health care facilities within 90days.
Objective: The objective of this study was to determine treatment outcome of community acquired pneumonia among hospitalized pediatric patients.
Infect Control Hosp Epidemiol
December 2024
Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA.
Objective: To determine whether differences exist in antibiotic prescribing for respiratory infections in pediatric urgent cares (PUCs) by patient race/ethnicity, insurance, and language.
Design: Multi-center cohort study.
Setting: Nine organizations (92 locations) from 22 states and Washington, DC.
Cancers (Basel)
November 2024
Preclinical Department, Faculty of Medicine, "Lucian Blaga" University of Sibiu, 550169 Sibiu, Romania.
Unlabelled: Capecitabine (CAP) is one of the most commonly prescribed fluoropyrimidines in oncology, especially in the treatment of colon cancer. Cardiac toxicity is a severe and potentially lethal adverse drug reaction (ADR) against fluoropyrimidines. Cardiac ADRs, such as myocardial infarction (MI), heart failure (HF), arrhythmias, and a number of cardiomyopathies, are reported for these molecules.
View Article and Find Full Text PDFJ Gen Intern Med
November 2024
Department of Medicine, Program On Regulation, Therapeutics, And Law, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Boston, MA, USA.
Background: The development of new infectious disease therapies has become a public health priority given the suboptimal efficacy and adverse effects with current drugs for some patients. Understanding the factors associated with physician antibiotic prescribing preferences can help guide policymakers seeking to incentivize the development of interventions that improve patient outcomes for the treatment and prevention of infectious diseases.
Objectives: To determine the factors associated with physician decision-making when prescribing antibiotics for community-acquired pneumonia (CAP), uncomplicated urinary tract infection (UTI), and cellulitis.
Antimicrob Steward Healthc Epidemiol
October 2024
Center for Value-based Care Research, Primary Care Institute, Cleveland Clinic, Cleveland, OH, USA.
Background: Community-acquired pneumonia (CAP) is a leading cause of hospitalizations and mortality in the US. Overuse of extended spectrum antibiotics (ESA) for CAP contributes to antimicrobial resistance. The 2019 Infectious Diseases Society of America/American Thoracic Society CAP guidelines emphasize de-escalation of ESA following negative cultures, early switch to oral (PO) antibiotics, and limited duration of therapy (DOT).
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