Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, Kentucky, USA.
Department of Oral Health Practice, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA.
J Public Health Dent. 2023 Jun;83(2):200-206. doi: 10.1111/jphd.12568. Epub 2023 Mar 11.
Reports of interventions to improve dental opioid prescribing have come primarily from academic settings, but most opioid prescriptions are written by community dentists. This analysis compares prescription characteristics between these two groups to inform interventions to improve dental opioid prescribing in community settings.
State prescription drug monitoring program data from 2013 to 2020 were used to compare opioid prescriptions from dentists at academic institutions (PDAI) to prescriptions from dentists in non-academic settings (PDNS). Linear regression was used to assess daily morphine milligram equivalents (MME), total MME, and days' supply, adjusting for year, age, sex, and rurality.
Prescriptions from dentists at the academic institution accounted for less than 2% of over 2.3 million dental opioid prescriptions analyzed. Over 80% of prescriptions in both groups were written for <50 MME per day and for ≤3 days' supply. On average, in the adjusted models, prescriptions from the academic institution were written for about 75 additional MME per prescription and nearly a full day longer duration. Compared to adults, adolescents were the only age group who received both higher daily doses and longer days' supply.
Prescriptions from dentists at academic institutions accounted for small percentage of opioid prescriptions, but prescription characteristics were clinically comparable between groups. Interventional targets to reduce opioid prescribing in academic institutions could be applied to community settings.
改善牙科阿片类药物处方的干预措施报告主要来自学术环境，但大多数阿片类药物处方是由社区牙医开具的。本分析比较了这两组的处方特征，以为社区环境中改善牙科阿片类药物处方提供信息。
使用 2013 年至 2020 年的州处方药监测计划数据，比较学术机构牙医（PDAI）和非学术环境牙医（PDNS）开具的阿片类药物处方。线性回归用于评估每日吗啡毫克当量（MME）、总 MME 和供应天数，同时调整年份、年龄、性别和农村性。
学术机构牙医开具的处方占分析的超过 230 万张牙科阿片类药物处方中不到 2%。两组中超过 80%的处方开具的每日 MME 少于 50 毫克，供应天数不超过 3 天。在调整后的模型中，平均而言，学术机构开具的处方每处方增加了约 75 个额外的 MME，持续时间延长了近一天。与成年人相比，青少年是唯一接受更高每日剂量和更长供应天数的年龄组。
学术机构牙医开具的处方占阿片类药物处方的比例很小，但两组的处方特征在临床上相似。减少学术机构阿片类药物处方的干预目标可以应用于社区环境。
