Heterogeneity in Prescription Opioid Misuse Motives by Age in Adolescents and Young Adults in the United States.

Objective: Adolescent (12-17 years) and young adult (18-25 years) prescription opioid misuse (POM) is linked to poor health outcomes. We investigated how POM motives vary across these ages and the potential links between motives and other substance use, mental health, and sociodemographic characteristics to help guide screening and prevention.

Methods: Pooled 2015-2019 US National Survey on Drug Use and Health data were used, with 137,858 participants.

Anticoagulation Stewardship to Bridge the Implementation Gap in Perioperative Anticoagulation Management.

Lack of alignment of care protocols among providers in health care is a driver of increased costs and suboptimal patient outcomes. Perioperative anticoagulation management is a good example of a complex area where protocol creation is a clinical challenge that demands input from multiple experts. Questions regarding the need for anticoagulation interruptions are frequent.

Trends and Distribution of In-Hospital Mortality Among Pregnant and Postpartum Individuals by Pregnancy Period.

This cross-sectional study investigates trends in death rates and proportion of deaths by pregnancy period among pregnant and postpartum individuals from 1994 to 2019.

Policies and Resources Identified by Youth as Being Important to Prepare for Caregiving Responsibilities.

Background: Youth are increasingly upholding significant caregiving responsibilities. These caregiving responsibilities can have emotional, educational, and professional impacts on youth and young adults. And yet, policies and resources focus on adult caregivers and are limited in supporting young caregivers.

Evaluation of Antipsychotic Reduction Efforts in Patients With Dementia in Veterans Health Administration Nursing Homes.

Objective: The Veterans Health Administration (VHA) and the Centers for Medicare and Medicaid Services (CMS) each created initiatives to reduce off-label use of antipsychotics in patients with dementia in nursing homes. Although CMS has reported antipsychotic reductions, the impact on prescribing of antipsychotic and other CNS-active medications in the VHA remains unclear. The authors evaluated national trends in antipsychotic and other CNS-active medication prescribing for nursing home patients with dementia in the VHA.

Neonatal Intensive Care Workflow Analysis Informing NEC-Zero Clinical Decision Support Design.

Decision support in neonatal ICUs is needed, especially for prevention and risk awareness of the devastating complication of necrotizing enterocolitis, a major cause of emergency surgery among fragile infants. The purpose of this study was to describe the current clinical workflow and sociotechnical processes among clinicians for necrotizing enterocolitis risk awareness, timely recognition of symptoms, and treatment to inform decision support design. A qualitative descriptive study was conducted.

Contribution of Individual- and Neighborhood-Level Social, Demographic, and Health Factors to COVID-19 Hospitalization Outcomes.

Background: Although disparities in COVID-19 outcomes have been observed, factors contributing to these differences are not well understood.

Objective: To determine whether COVID-19 hospitalization outcomes are related to neighborhood-level social vulnerability, independent of patient-level clinical factors.

Design: Pooled cross-sectional study of prospectively collected data.

AGA Clinical Practice Update on De-Prescribing of Proton Pump Inhibitors: Expert Review.

Description: Proton pump inhibitors (PPIs) are among the most commonly used medications in the world. Developed for the treatment and prevention of acid-mediated upper gastrointestinal conditions, these agents are being used increasingly for indications where their benefits are less certain. PPI overprescription imposes an economic cost and contributes to polypharmacy.

Pain Phenotypes in Adults Living With Cerebral Palsy.

Background And Objectives: To identify pain phenotypes among adults living with cerebral palsy (CP) and compare phenotypes of pain intensity, anxiety and depressive symptoms, and self-reported perceived stress.

Methods: Seventy-one adults with CP presented to the University of Michigan (mean age = 39.3 ± 16.

Adherence to Antiseizure vs Other Medications Among US Medicare Beneficiaries With and Without Epilepsy.

Background And Objective: The objectives of this study were to compare adherence to antiseizure medications (ASMs) vs non-ASMs among individuals with epilepsy, to assess the degree to which variation in adherence is due to differences between individuals vs between medication classes among individuals with epilepsy, and to compare adherence in individuals with vs without epilepsy.

Methods: This was a retrospective cohort study using Medicare. We included beneficiaries with epilepsy (≥1 ASM, plus ICD-9-CM diagnostic codes) and a 20% random sample without epilepsy.

Adding a New Medication Versus Maximizing Dose to Intensify Hypertension Treatment in Older Adults : A Retrospective Observational Study.

Background: There are 2 approaches to intensifying antihypertensive treatment when target blood pressure is not reached, adding a new medication and maximizing dose. Which strategy is better is unknown.

Objective: To assess the frequency of intensification by adding a new medication versus maximizing dose, as well as the association of each method with intensification sustainability and follow-up systolic blood pressure (SBP).

Telehealth-based Eye Care During the COVID-19 Pandemic: Utilization, Safety, and the Patient Experience.

Purpose: To assess the initial utilization, safety, and patient experience with tele-ophthalmology during the COVID-19 pandemic.

Design: Cross-sectional study.

Methods: We conducted a telephone survey and interview of a random sample of patients who received different modalities of care (in-person, telephone, videocall, or visits deferred) during Michigan's shelter-in-place order beginning March 23, 2020.

Perspectives of US Adolescents on Diverted Stimulant Use.

Objective: To evaluate perspectives of youth regarding diverted stimulant use among a contemporary sample of adolescents and young adults.

Study Design: This study used MyVoice, a longitudinal national text message survey of American youth. In February 2019, 1228 MyVoice youth were asked 4 open-ended questions to elicit their perspectives on diverted stimulant use.