Article
Surgery
Ryan Howard, Craig S. Brown, Yen-Ling Lai, Vidhya Gunaseelan, Chad M. Brummett, Michael Englesbe, Jennifer Waljee, Mark C. Bicket
Summary: This study aimed to evaluate the association between postoperative opioid prescribing and new persistent opioid use. The results showed that the quantity of opioids prescribed after surgery was associated with new persistent opioid use, indicating that excessive prescribing increases the risk of long-term opioid use.
Article
Health Care Sciences & Services
Peter Treitler, Hillary Samples, Richard Hermida, Stephen Crystal
Summary: The implementation of New Jersey's opioid prescribing limit policy led to an increase in new opioid prescriptions and initial prescriptions with supply on day 90. While the policy did decrease the percentage of new prescriptions with > 5 days' supply, it did not result in an overall decline in new opioid prescriptions or in the rate of transitions to long-term use.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2023)
Article
Surgery
Richard J. Barth Jr, Eleah D. Porter, Julia L. Kelly, Sarah Y. Bessen, Lida B. Molloy, Joseph D. Phillips, Andrew P. Loehrer, Matthew Z. Wilson, Srinivas J. Ivatury, Sarah E. Billmeier, John D. Seigne, Sandra L. Wong, Ivy Wilkinson-Ryan
Summary: The aim of this study was to determine the frequency and reasons for long-term opioid prescriptions after surgery in the setting of guideline-directed prescribing and a high rate of excess opioid disposal. The results showed that 15.3% of patients filled an opioid prescription 3 to 12 months after surgery, mainly due to new painful medical conditions and new surgeries. The conclusion is that none of the patients in this study became persistent opioid users solely as a result of the opioid prescription given after their index surgery.
Article
Surgery
Jordanne Ford, Tammy Kindel, Rana M. Higgins, Kathleen L. Lak, Emily Hetzel, Jon C. Gould
Summary: Research revealed a gap between the amount of opioid medication prescribed and taken by patients post-bariatric surgery. Patients least satisfied with pain control had lower understanding of pain control options compared to more satisfied patients.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2022)
Article
Geriatrics & Gerontology
Mingyang Sun, Wan-Ming Chen, Szu-Yuan Wu, Jiaqiang Zhang
Summary: This study investigated the association between long-term opioid use and the risk of dementia in patients with chronic pain. The results showed that long-term opioid use may be associated with an increased risk of dementia. These findings highlight the need for cautious prescribing and monitoring of opioid use in this population.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2023)
Article
Health Care Sciences & Services
Alexis K. Barrett, Friedhelm Sandbrink, Aram Mardian, Elizabeth M. Oliva, Virginia Torrise, Rongping Zhang, Kenneth Bukowski, Muriel Burk, Francesca E. Cunningham
Summary: This study describes the changes in opioid de-prescribing practices after the implementation of the Opioid Safety Initiative (OSI). The results suggest that veterans who discontinued high-dose long-term opioids in FY17 were more optimally managed compared to those in FY13. However, the interpretation of the findings is limited due to the study design.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2022)
Article
Medicine, General & Internal
Bridget L. Findlay, Cameron J. Britton, Amy E. Glasgow, Matthew T. Gettman, Mark D. Tyson, Raymond W. Pak, Boyd R. Viers, Elizabeth B. Habermann, Matthew J. Ziegelmann
Summary: The study assessed longitudinal prescribing patterns for patients undergoing urologic surgery before and after implementation of an evidence-based opioid prescribing guideline. The results showed a significant decrease in opioid quantity prescribed after guideline implementation, with overall guideline adherence at 90.7%. Despite the decrease in opioids prescribed, patients post-guideline implementation obtained fewer refills compared to pre-guideline implementation.
MAYO CLINIC PROCEEDINGS
(2021)
Article
Emergency Medicine
Quentin R. Reuter, Amanda Dos Santos, Jamie McKinnon, David Gothard, Nicholas Jouriles, David Seaberg
Summary: Medication for Opioid Use Disorder (MOUD) has been proven to be effective in reducing mortality, overdoses, and increasing treatment retention for patients with opioid use disorder (OUD). This study examined the long-term treatment retention outcomes of patients enrolled in MOUD from the emergency department (ED) and found that the ED-initiated MOUD program, in partnership with local addiction medicine services, achieved high rates of long-term treatment retention.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2022)
Article
Health Care Sciences & Services
Iraklis E. Tseregounis, Daniel J. Tancredi, Susan L. Stewart, Aaron B. Shev, Andrew Crawford, James J. Gasper, Garen Wintemute, Brandon D. L. Marshall, Magdalena Cerda, Stephen G. Henry
Summary: This study developed and validated a model to predict the risk of previously opioid-naive patients transitioning to long-term opioid use, showing high discrimination and calibration. The model has potential for integration into Prescription Drug Monitoring Programs to assist clinicians in opioid prescribing decisions.
Article
Multidisciplinary Sciences
Siyana Kurteva, Michal Abrahamowicz, Daniala Weir, Tara Gomes, Robyn Tamblyn
Summary: This study aimed to identify factors affecting long-term opioid therapy (LTOT) among patients recently discharged from hospital. The study found that factors such as having no drug copay status, previous use of LTOT, history of benzodiazepine use, being a cardiothoracic surgical patient, and initial high opioid dosage were associated with an increased likelihood of LTOT.
Article
Surgery
Gracia M. Vargas, Vidhya Gunaseelan, Lily Upp, Katherine J. Deans, Peter C. Minneci, Samir K. Gadepalli, Michael J. Englesbe, Jennifer F. Waljee, Calista M. Harbaugh
Summary: In this study, we examined postoperative opioid prescribing practices and their association with persistent opioid use among adolescents and young adults. The study found that high-risk opioid prescribing practices, particularly receiving prescriptions from multiple prescribers across specialties, significantly increased the risk of persistent opioid use among these patients.
Article
Anesthesiology
Jeffrey F. Scherrer, Joanne Salas, Lisa R. Miller-Matero, Mark D. Sullivan, Jane C. Ballantyne, Lynn Debar, Richard A. Grucza, Patrick J. Lustman, Brian Ahmedani
Summary: Long-term opioid therapy (LTOT) is associated with increased risk for depression. Patients who frequently or daily use opioids during LTOT are more likely to develop new-onset depression compared with occasional users. In LTOT, the risk for new depression episodes is up to 40% greater in near-daily users.
Article
Emergency Medicine
Tucker Lurie, Naomi Bonnin, Jeffrey Rea, Gurshawn Tuteja, Zachary Dezman, R. Gentry Wilkerson, Adelina Buganu, Rose Chasm, Daniel J. Haase, Quincy K. Tran
Summary: This study shows that emergency clinicians increased the prescribed amount of opioids per prescription during the COVID-19 pandemic compared to the pre-pandemic period.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2022)
Article
Surgery
Josh Bleicher, Zachary Fender, Jordan E. Johnson, Brian T. Cain, Kathy Phan, Damien Powers, Guo Wei, Angela P. Presson, Alvin Kwok, T. Bartley Pickron, Courtney L. Scaife, Lyen C. Huang
Summary: This study aimed to understand patients' postoperative opioid consumption patterns and evaluate the adequacy of discharge prescriptions. Despite adherence to national guidelines, patients received excessive opioid prescriptions. The formula 2 x 24-h PDOC was proposed to improve prescribing practices.
AMERICAN JOURNAL OF SURGERY
(2022)
Article
Surgery
Hannah Wunsch, Andrea D. Hill, Jennifer Bethell, Longdi Fu, Brian T. Bateman, Karim S. Ladha, Duminda N. Wijeysundera, Mark D. Neuman
Summary: This study aimed to determine the relationship between surgeon opioid prescribing intensity and subsequent persistent opioid use among surgical patients. The researchers found that surgeons' overall prescribing practices may contribute to persistent opioid use and can be targeted for quality improvement.
Article
Health Policy & Services
Sadiq Y. Patel, Haiden A. Huskamp, Michael L. Barnett, Jose R. Zubizarreta, Kori S. Zachrison, Alisa B. Busch, Andrew D. Wilcock, Ateev Mehrotra
Summary: Due to limited access to psychiatrists, patients with acute mental illness in some emergency departments may wait days for consultation or admission. A study found that telepsychiatry can improve access to care but may increase ED wait times and hospital admissions.
PSYCHIATRIC SERVICES
(2022)
Article
Immunology
Stephen M. Kissler, Bill Wang, Ateev Mehrotra, Michael Barnett, Yonatan H. Grad
Summary: Privately insured children in the United States receive many antibiotics early in life, largely due to respiratory infections. Antibiotic dispensing varies widely among children, with more antibiotics dispensed to children with pulmonary/respiratory, otologic, and/or immunological comorbidities.
CLINICAL INFECTIOUS DISEASES
(2023)
Editorial Material
Medicine, General & Internal
Michael L. Barnett, Paul E. Sax
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2023)
Article
Geriatrics & Gerontology
Agne Ulyte, Ateev Mehrotra, Haiden A. Huskamp, David C. Grabowski, Michael L. Barnett
Summary: The use of specialty care significantly decreases after patients transition to a nursing home. Residents who require specialty care have fewer visits after the transition, with a decreasing trend in all specialties. Patients with severe conditions have a larger decrease. Among residents who continue to visit specialists, 78.9% see the same provider as before the transition.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2023)
Article
Medicine, General & Internal
Anna L. Goldman, Michael L. Barnett
Summary: This study found that physician work hours have consistently declined in the past 20 years, resulting in physician workforce hours per capita lagging behind US population growth. However, the hours contributed by advanced practice professionals have rapidly increased, potentially leading to diverging implications for gender equity.
JAMA INTERNAL MEDICINE
(2023)
Article
Geriatrics & Gerontology
Amanda C. C. Chen, Arnold M. Epstein, Karen E. Joynt E. Maddox, David C. Grabowski, E. John Orav, Michael L. Barnett
Summary: The study aims to investigate the care delivery approaches and perceived barriers of skilled nursing facilities (SNFs) in providing care for short-stay residents. The findings suggest that there is a wide range of care delivery approaches implemented by SNFs, but staffing issues and limited resources are the dominant barriers to care delivery.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2023)
Article
Medicine, General & Internal
Brian E. McGarry, Ashvin D. Gandhi, Michael L. Barnett
Summary: A study found that widespread surveillance testing among staff members in nursing homes can reduce Covid-19 cases and deaths among residents, especially before the availability of vaccines.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Medicine, General & Internal
Michael L. L. Barnett, Ellen Meara, Terri Lewinson, Brianna Hardy, Deanna Chyn, Moraa Onsando, Haiden A. A. Huskamp, Ateev Mehrotra, Nancy E. E. Morden
Summary: An analysis of Medicare claims data from 2016-2019 revealed that white patients were more likely to receive medications for opioid use disorder (OUD) compared to black and Hispanic patients. Despite an increase in opioid overdose-related mortality among black individuals, racial and ethnic disparities in the use of OUD medications remained consistent and substantial over time.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Editorial Material
Health Care Sciences & Services
Suhas Gondi, Michael L. Barnett
Article
Geriatrics & Gerontology
Amanda C. Chen, Arnold M. Epstein, Karen E. Joynt Maddox, David C. Grabowski, E. John Orav, Michael L. Barnett
Summary: This study investigated the association between dementia-focused care strategies and clinical outcomes, utilization, and costs for short-stay dementia patients in nursing homes. The results showed that the presence of dementia care units was associated with improved outcomes, while cognitive deficiency training and dementia-specific occupational therapy had mixed effects.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2023)
Letter
Medicine, General & Internal
Max Jordan Nguemeni Tiako, Autumn Nobles, Muzzammil Muhammad, Marcella Nunez-Smith, Michael Barnett
ANNALS OF INTERNAL MEDICINE
(2023)
Meeting Abstract
Public, Environmental & Occupational Health
Nazleen Khan, Katsiaryna Bykov, Michael Barnett, Robert Glynn, Seanna Vine, Joshua J. Gagne
PHARMACOEPIDEMIOLOGY AND DRUG SAFETY
(2022)
Article
Health Care Sciences & Services
Arno Cai, Ateev Mehrotra, Hayley D. Germack, Alisa B. Busch, Haiden A. Huskamp, Michael L. Barnett
Summary: The supply of psychiatrists is inadequate to meet the demand for mental health care in the United States, but psychiatric mental health nurse practitioners (PMHNPs) are experiencing significant growth and could help address the widening gap. From 2011 to 2019, the number of PMHNPs treating Medicare beneficiaries increased while the number of psychiatrists decreased. This shift has led to changes in practice patterns and an overall decrease in mental health office visits.
Article
Computer Science, Information Systems
Xiyu Ding, Michael Barnett, Ateev Mehrotra, Delphine S. Tuot, Danielle S. Bitterman, Timothy A. Miller
Summary: This study aims to develop machine learning models for classifying the type and content of eConsult questions and investigate the ability to solve this task with limited expert time resources. The results show that multitask learning can help reduce labeling effort in certain cases, but sharing information across classifier types has little benefit, while sharing classifier components across specialties can improve classification performance.
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION
(2022)
Article
Health Care Sciences & Services
Sadiq Y. Patel, Haiden A. Huskamp, Austin B. Frakt, David Auerbach, Hannah T. Neprash, Michael L. Barnett, Hannah O. James, Ateev Mehrotra
Summary: Nurse practitioners (NPs) and physician assistants (PAs) are playing an increasingly important role in the healthcare workforce. However, due to indirect billing practices, much of the care they provide is not reflected in claims data. By using prescriptions to identify indirectly billed visits, it was found that the number of such visits has been increasing over the years. Eliminating indirect billing could result in significant cost savings for Medicare, particularly impacting smaller primary care practices.