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Prescription Opioid Exposure During Pregnancy and Risk of Spontaneous Preterm Delivery.
JAMA Netw Open
February 2024
Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, Tennessee.
Importance: Opioid exposure during pregnancy has been associated with preterm birth, but prior studies have not differentiated between spontaneous and indicated preterm birth or fully investigated these associations as functions of opioid dose.
Objective: To determine whether prescription opioid use during pregnancy is associated with spontaneous preterm birth and whether the association is dose-dependent.
Design, Setting, And Participants: This case-control study examined a retrospective cohort of pregnant patients enrolled in Tennessee Medicaid.
Risk of Death at 1 Year Following Postpartum Opioid Exposure.
Am J Perinatol
May 2024
Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee.
Objective: Opioids are commonly prescribed to women for acute pain following childbirth. Postpartum prescription opioid exposure is associated with adverse opioid-related morbidities but the association with all-cause mortality is not well studied. This study aimed to examine the association between postpartum opioid prescription fills and the 1-year risk of all-cause mortality among women with live births.
View Article and Find Full Text PDFAn algorithm using administrative data to measure adverse childhood experiences (ADM-ACE).
Health Serv Res
August 2022
Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Objective: To develop an algorithm using administrative data to measure adverse childhood experiences (ADM-ACE) within routinely collected health insurance claims and enrollment data.
Data Sources: We used claims and enrollment data from Tennessee's Medicaid program (TennCare) in 2018.
Study Design: We studied five types of ACEs: maltreatment and peer violence, foster care and family disruption, maternal mental illness, maternal substance use disorder, and abuse of the mother.
The Impact of the Human Papillomavirus Vaccine on High-Grade Cervical Lesions in Urban and Rural Areas: An Age-Period-Cohort Analysis.
Cancers (Basel)
August 2021
Department of Behavioral Science, University of Kentucky Markey Cancer Center, Lexington, KY 40504, USA.
Disparities in human papillomavirus (HPV) vaccination exist between urban (metropolitan statistical areas (MSAs)) and rural (non-MSAs) regions. To address whether the HPV vaccine's impact differs by urbanicity, we examined trends in cervical intraepithelial neoplasia grades 2 or 3 and adenocarcinoma in situ (collectively, CIN2+) incidence in MSAs and non-MSAs among Tennessee Medicaid (TennCare)-enrolled women aged 18-39 years and among the subset screened for cervical cancer in Tennessee, United States. Using TennCare claims data, we identified annual age-group-specific (18-20, 21-24, 25-29, 30-34, and 35-39 years) CIN2+ incidence (2008-2018).
View Article and Find Full Text PDFQuality improvement in hepatitis C screening and treatment in a primary care resident clinic.
J Community Hosp Intern Med Perspect
December 2019
St Thomas Health Department of Internal Medicine, University of Tennessee Health Science Center, Nashville, TN, USA.
Quality improvement projects are an important part of education for residents and outcome-based projects, and data are required by ACGME. Our resident clinic conducted a quality improvement project regarding screening and treatment for hepatitis C. We improved our screening rate per CDC guidelines and found a prevalence of 1.
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