Abstract
Introduction: The objective of this study is to identify county-level characteristics that may be high-impact targets for opioid and antibiotic interventions to improve dental prescribing. Methods: Prescriptions during 2012–2017 were extracted from the IQVIA Longitudinal Prescription database. Primary outcomes were yearly county-level antibiotic and opioid prescribing rates. Multivariable negative binomial regression identified associations between prescribing rates and county-level characteristics. All analyses occurred in 2020. Results: Over time, dental opioid prescribing rates decreased by 20% (from 4.02 to 3.22 per 100 people), whereas antibiotic rates increased by 5% (from 6.85 to 7.19 per 100 people). Higher number of dentists per capita, higher proportion of female residents, and higher proportion of residents aged <65 years were associated with increased opioid rates. Relative to location in the West, location in the Northeast (59%, 95% CI=52, 65) and Midwest (64%, 95% CI=60, 70) was associated with lower opioid prescribing rates. Higher clinician density, median household income, proportion female, and proportion White were all independently associated with higher antibiotic rates. Location in the Northeast (149%, 95% CI=137, 162) and Midwest (118%, 95% CI=111, 125) was associated with higher antibiotic rates. Opioid and antibiotic prescribing rates were positively associated. Conclusions: Dental prescribing of opioids is decreasing, whereas dental antibiotic prescribing is increasing. High prescribing of antibiotics is associated with high prescribing of opioids. Strategies focused on optimizing dental antibiotics and opioids are needed given their impact on population health.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 648-657 |
| Number of pages | 10 |
| Journal | American Journal of Preventive Medicine |
| Volume | 60 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 2021 |
Funding
The content of this study is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality, Department of Veterans Affairs, U.S. government, or IQVIA or any of its affiliated entities. The statements, findings, conclusions, views, and opinions contained and expressed in this article are based in part on data obtained under license from IQVIA (source: Longitudinal Prescription January 2012 to December 2017, IQVIA Inc.). All rights reserved. The research reported in this publication was supported by the Agency for Healthcare Research and Quality under award number R01 HS25177 (Principal Investigator: KJS). The sponsor had no role in the design or conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. Author responsibilities were as follows: CCH completed the analysis; CCH, GSC, SAR, WFG, AC, AEG, RCH, JCM, and LKS contributed to the writing; KJS led writing; CTE, GSC, SAR, WFG, AEG, RCH, JCM, and LKS assisted with the study design; CTE, GSC, and WFG assisted with the analysis; SAR, WFG, AC, AEG, RCH, JCM, LKS, and KJS conducted the critical evaluation of the results; AC led data acquisition and assisted with variable definitions; and KJS conceived and supervised the study. This work was presented in part at the International Conference on Health Policy Statistics in San Diego, California, in January 2020. GSC is an employee of Flatiron Health. AC is an employee of IQVIA. No other financial disclosures were reported.
ASJC Scopus subject areas
- Epidemiology
- Public Health, Environmental and Occupational Health