J Am Dent Assoc. 2021 Aug;152(8):622-630.e3. doi: 10.1016/j.adaj.2021.04.013.
The authors examined trends in opioid prescriptions by dentists for children and nonsenior adults enrolled in Medicaid.
The authors used the IBM Watson Medicaid claims databases for 2012 through 2019 and the Centers for Disease Control and Prevention conversion data set. Opioid prescriptions were linked to a dental visit when prescribed within 3 days of the dental visit and if the patient had no medical visit reported during that period. The authors conducted descriptive analyses for age, procedures performed, treatment history, and prescription strength.
The results of the study showed consistent decreases in opioid prescription rates in dentistry during the study period from 2.7% to 1.6% among children (aged 0-20 years) and from 28.6% to 12.2% for adults (aged 21-64 years). The adult opioid prescription rate decreased for nonsurgical dental procedures from 9.7% to 2.9%. For surgical procedures, the adult prescription rate decreased from 48.0% to 28.7%. Most dental-related opioids were prescribed for oral surgeries (children, 70.8%; adults, 58.6%). By 2019, 23% of all opioid prescriptions for children were dental related.
The authors found that opioid prescription rates in dentistry for people enrolled in Medicaid declined substantially from 2012 through 2019 for both children and adults. The percentage of prescriptions written for nonsurgical visits consistently declined over the observed time. During the same time, opioid prescription rates for both dental surgical procedures and dental nonsurgical procedures.
Although the trends revealed in the analysis show declining opioid prescription patterns, these results suggest that the overall rate is still too high and prescriptions are being written unnecessarily.
作者研究了参加医疗补助计划的牙医为儿童和非老年人开具阿片类药物处方的趋势。
作者使用 IBM Watson 医疗补助索赔数据库和疾病控制与预防中心的转换数据集,对 2012 年至 2019 年的数据进行分析。当阿片类药物处方是在牙科就诊后 3 天内开具,且患者在该期间没有医疗就诊记录时,将其与牙科就诊相关联。作者对年龄、实施的程序、治疗史和处方强度进行了描述性分析。
研究结果显示,在研究期间,儿童(0-20 岁)的牙科阿片类药物处方率从 2.7%降至 1.6%,成人(21-64 岁)的处方率从 28.6%降至 12.2%,呈持续下降趋势。非手术牙科程序的成人阿片类药物处方率从 9.7%降至 2.9%。对于手术程序,成人处方率从 48.0%降至 28.7%。大多数与牙科相关的阿片类药物用于口腔手术(儿童,70.8%;成人,58.6%)。到 2019 年,所有儿童阿片类药物处方中,有 23%与牙科相关。
作者发现,2012 年至 2019 年期间,参加医疗补助计划的儿童和成人的牙科阿片类药物处方率大幅下降。观察期间,非手术就诊的处方比例持续下降。与此同时,牙科手术和非手术程序的阿片类药物处方率也有所下降。
尽管分析中显示的趋势表明阿片类药物处方模式呈下降趋势,但这些结果表明总体比率仍然过高,处方开具存在不必要的情况。