Journal
AMERICAN JOURNAL OF PREVENTIVE MEDICINE
Volume 62, Issue 3, Pages 317-325Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.amepre.2021.09.017
Keywords
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Funding
- Benter Foundation [2020-02]
- Substance Abuse and Mental Health Services Administration
- University of Michigan Precision Health Initiative
- National Institute on Drug Abuse [1K08DA048110-01]
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This study investigates whether certain dentists account for disproportionate shares of dental opioid prescriptions and high-risk prescriptions, and identifies characteristics associated with being a high-volume dentist.
Introduction: It is unknown whether certain dentists account for disproportionate shares of dental opioid prescriptions and high-risk prescriptions. Identifying and characterizing such dentists could inform the targeting of initiatives to improve the appropriateness and safety of dental opioid prescribing. Methods: In May 2021, the authors conducted a cross-sectional analysis using the IQVIA Longitudinal Prescription Database, which reports dispensing from 92% of U.S. pharmacies, and 2 provider opioid prescriptions from dentists dispensed in 2019 to patients aged >12 years. High-risk prescriptions were those considered high risk by any of 3 metrics (prescriptions to opioid-naive patients exceeding a 3-day supply, prescriptions with daily opioid dosage >= 50 morphine milligram equivalents, opioid prescriptions with benzodiazepine overlap). Among all prescriptions and high-risk prescriptions, the authors calculated the proportion accounted for by high-volume dentists - those with prescription counts in the 95th percentile or higher. Using logistic regression, the characteristics associated with being a high-volume dentist were identified. Results: In 2019, a total of 141,345 dentists accounted for 10,736,743 opioid prescriptions dispensed to patients aged >12 years; 4,242,634 (39.5%) were high-risk prescriptions. The 7,079 high-volume dentists, a group representing 5.0% of the 141,345 dentists, accounted for 46.9% of all prescriptions and 47.5% of high-risk prescriptions. Male sex, younger age, non-Northeast location, and specialization in oral and maxillofacial surgery were associated with a higher risk of being a high-volume dentist. Conclusions: In 2019, high-volume dentists accounted for almost half of dental opioid prescriptions and high-risk prescriptions. Quality improvement initiatives targeting these dentists may be warranted. Am J Prev Med 2022;62(3):317-325. (c) 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
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