scholarly journals Opioid Utilization and Perception of Pain Control in Hospitalized Patients: A Cross-Sectional Study of 11 Sites in 8 Countries

2019 ◽  
Vol 14 (12) ◽  
pp. 737-745 ◽  
Author(s):  
Marisha Burden ◽  
Angela Kingston ◽  
Mary Anderson Wallace ◽  
Jason W Busse ◽  
Jordi Casademont ◽  
...  
Keyword(s):  
Pain Control ◽  
Opioid Analgesics ◽  
The United States ◽  
Cross Sectional Study ◽  
Hospitalized Patients ◽  
Prescribing Patterns ◽  
Opioid Use ◽  
Prescribing Practices ◽  
Cross Sectional ◽  
The Us

BACKGROUND: Hospitalized patients are frequently treated with opioids for pain control, and receipt of opioids at hospital discharge may increase the risk of future chronic opioid use. OBJECTIVE: To compare inpatient analgesic prescribing patterns and patients’ perception of pain control in the United States and non-US hospitals. DESIGN: Cross-sectional observational study. SETTING: Four hospitals in the US and seven in seven other countries. PARTICIPANTS: Medical inpatients reporting pain. MEASUREMENTS: Opioid analgesics dispensed during the first 24-36 hours of hospitalization and at discharge; assessments and beliefs about pain. RESULTS: We acquired completed surveys for 981 patients, 503 of 719 patients in the US and 478 of 590 patients in other countries. After adjusting for confounding factors, we found that more US patients were given opioids during their hospitalization compared with patients in other countries, regardless of whether they did or did not report taking opioids prior to admission (92% vs 70% and 71% vs 41%, respectively; P < .05), and similar trends were seen for opioids prescribed at discharge. Patient satisfaction, beliefs, and expectations about pain control differed between patients in the US and other sites. LIMITATIONS: Limited number of sites and patients/ country. CONCLUSIONS: In the hospitals we sampled, our data suggest that physicians in the US may prescribe opioids more frequently during patients’ hospitalizations and at discharge than their colleagues in other countries, and patients have different beliefs and expectations about pain control. Efforts to curb the opioid epidemic likely need to include addressing inpatient analgesic prescribing practices and patients’ expectations regarding pain control.

Current Opioid Prescribing Patterns after Microdirect Laryngoscopy

2019 ◽  
Vol 129 (2) ◽  
pp. 142-148 ◽  
Author(s):  
Molly N. Huston ◽  
Rouya Kamizi ◽  
Tanya K. Meyer ◽  
Albert L. Merati ◽  
John Paul Giliberto
Keyword(s):  
The United States ◽  
Opioid Abuse ◽  
Prescribing Patterns ◽  
Opioid Analgesia ◽  
Opioid Use ◽  
Prescribing Practices ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Opioid Prescription ◽  
Opioid Prescribing

Background: The prevalence of opioid abuse has become epidemic in the United States. Microdirect laryngoscopy (MDL) is a common otolaryngological procedure, yet prescribing practices for opioids following this operation are not well characterized. Objective: To characterize current opioid-prescribing patterns among otolaryngologists performing MDL. Methods: A cross-sectional survey of otolaryngologists at a national laryngology meeting. Results: Fifty-eight of 205 physician registrants (response rate 28%) completed the survey. Fifty-nine percent of respondents were fellowship-trained in laryngology. Respondents performed an average of 13.3 MDLs per month. Thirty-four percent of surgeons prescribe opioids for over two-thirds of their MDLs, while only 7% of surgeons never prescribe opioids. Eighty-eight percent of surgeons prescribed a combination opioid and acetaminophen compound, hydrocodone being the most common opioid component. Many surgeons prescribe non-opioid analgesics as well, with 70% and 84% of surgeons recommending acetaminophen and ibuprofen after MDL respectively. When opioids were prescribed, patient preference, difficult exposure and history of opioid use were the most influential patient factors. Concerns of opioid abuse, the physician role in the opioid crisis, and literature about postoperative non-opioid analgesia were also underlying themes in influencing opioid prescription patterns after MDL. Conclusions: In this study, over 90% of practicing physicians surveyed are prescribing opioids after MDL, though many are also prescribing non-opioid analgesia as well. Further studies should be completed to investigate the needs of patients following MDL in order to allow physicians to selectively and appropriately prescribe opioid analgesia postoperatively.

scholarly journals A cross-sectional study of opioid involvement in non-poisoning suicide – risks and prevention opportunities

2020 ◽  
Author(s):  
Maryann Mason ◽  
Suzanne McLone ◽  
Tami Bartell ◽  
Sarah Welch ◽  
Karen Sheehan ◽  
...  
Keyword(s):  
United States ◽  
Suicide Prevention ◽  
The United States ◽  
Cross Sectional Study ◽  
Close Monitoring ◽  
Opioid Epidemic ◽  
Sectional Study ◽  
Opioid Use ◽  
Chi Square ◽  
Cross Sectional

Abstract Background The current opioid epidemic has drawn attention to drug overdose deaths including unintentional and suicide poisoning deaths which peaked in the United States in 2017. Concurrent with the opioid epidemic, the number and rate of suicides in the United States has increased. At the same time, the proportion of suicide deaths across cause of death has shifted and the proportion of suicides by poisoning (including overdose) has decreased. On the face of it, it would appear that the opioid epidemic has not intersected with suicide as signaled by the decline in suicide deaths due to poisoning. However, opioid use and misuse is associated with suicidal ideation and attempts and therefore it is plausible that opioids may play a role in suicide deaths by causes other than poisoning. Objective This study examines opioid involvement (as measured by the presence of opioids but below the lethality threshold) in suicides by causes other than poisoning, Methods A cross-sectional study utilizing Illinois National Violent Death Reporting System data including all suicides toxicology screened for opioids. Chi-square tests were used to compare decedent and incident circumstance characteristics by opioid toxicology screen status. Results Of 1007 non-poisoning suicides screened for opioids, 83.6% (842) were opioid negative and 16.4% (165) were opioid positive. Over half (52.7%) of decedents positive for opioids died by firearm. White race, age 75 and over, and widowed or unknown marital status were associated with opioid positivity. Opioid positivity is linked to testing positive for other substances. One quarter of decedents testing positive for opioids had a history of substance abuse. Twenty eight percent of opioid positive decedents suffered from physical health problems. Conclusion Suicide decedents who are opioid positive and who die from causes other than poisoning have distinct characteristics which suggest an array of suicide prevention efforts – for example -- including information on risk of suicide for opiate users in firearm sales, including suicide prevention counseling in health care settings in which opiates and/or benzodiazepines are therapeutically prescribed, and close monitoring of pain symptoms among patients experiencing chronic pain. ​

scholarly journals Income-based inequalities in self-reported moderate-to-vigorous physical activity among adolescents in England and the United States: a cross-sectional study

2020 ◽  
Author(s):  
Shaun Scholes ◽  
Jennifer S Mindell
Keyword(s):  
Physical Activity ◽  
Low Income ◽  
Vigorous Physical Activity ◽  
The United States ◽  
Cross Sectional Study ◽  
High Income ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Us ◽  
Low Income Households

Objective: Quantify inequalities in self-reported moderate-to-vigorous physical activity (MVPA) in England and the United States (US). Design: Population-based cross-sectional study. Participants: 4019 adolescents aged 11-15 years in England (Health Survey for England 2008, 2012, 2015) and 4312 aged 12-17 years in the US (National Health and Nutrition Examination Survey 2007-16). Main outcome measures: Three aspects of MVPA: (1) doing any, (2) average min/day (MVPA: including those who did none), and (3) average min/day conditional on participation (MVPA-active). Using hurdle models, we quantified inequalities (average marginal effects: AMEs) using the absolute difference in marginal means. Results: In England, adolescents in high-income households were more likely than those in low-income households to have done any formal sports/exercise in the last seven days (boys: 11%; 95% CI: 4% to 17%; girls: 13%; 95% CI: 6% to 20%); girls in high-income households did more than their low-income counterparts (MVPA: 6 min/day, 95% CI: 2 to 9). Girls in low-income households spent more time in informal activities than girls in high-income households (MVPA: 21 min/day; 95% CI: 10 to 33), whilst boys in low-income versus high-income households spent longer in active travel (MVPA: 21 min/week; 95% CI: 8 to 34). In the US, in a typical week, recreational activity was greater among high-income versus low-income households (boys: 15 min/day; 95% CI: 6 to 24 min/day; girls: 19 min/day; 95% CI: 12 to 27). In contrast, adolescents in low-income versus high-income households were more likely to travel actively (boys: 11%; 95% CI: 3% to 19%; girls: 10%; 95% CI: 3% to 17%) and do more. Conclusions: Policy actions and interventions are required to increase MVPA across all income groups in England and the US. Differences in formal sports/exercise (England) and recreational (US) activities suggest that additional efforts are required to reduce inequalities.

scholarly journals Gender Disparities of Heart Disease and the Association with Smoking and Alcohol Drinking Behavior Among the Middle-Aged and Older Population in the US and China, a Cross-Sectional Study of CHARLS and HRS Data

2021 ◽  
Author(s):  
Yifei Li ◽  
Yuanan Lu ◽  
Eric L. Hurwitz ◽  
Yanyan Wu
Keyword(s):  
Heart Disease ◽  
Gender Gap ◽  
Alcohol Drinking ◽  
Survey Design ◽  
Drinking Behavior ◽  
The United States ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Disease Etiology ◽  
The Us

Abstract Background Heart disease remains the leading cause of death globally with substantial variabilities in mortalities by gender and region. Smoking and alcohol drinking are known modifiable health behaviors associated with heart disease. This study aims to estimate the prevalence of heart disease and to examine the association with smoking and drinking behavior for men and women in the United States (US) and China. Methods This study utilized the Harmonized data from the US Health and Retirement Study (HRS) and the China Health and Retirement Longitudinal Study (CHARLS), which are sister surveys as part of the Gateway to Global Aging Data (https://g2aging.org/). We performed cross-sectional comparisons using the 2016 wave HRS and 2015 wave CHARLS data. Age was categorized into four groups (50–59, 60–69, 70–79, and 80 years or older) and smoking and drinking behavior were combined to neither, smoking only, drinking only and both behaviors. Weighted analyses were conducted to estimate the prevalence and prevalence ratios (PRs) of heart disease accounting for complex survey design. Results The overall prevalence of heart disease was higher in men (24.5%) than in women (20.6%) in the US. In contrast, women had higher prevalence (22.9%) than men (16.1%) in China. The prevalence of heart disease increased by age with increasing gender gap in the US, while in China, the highest prevalence was observed in the 70–79 age group and gender difference were more apparent before 80 years of age. Adjusting for socio-demographic variables and health conditions, smoking only was associated with a higher prevalence of heart disease in both countries and the associations were stronger among women (US: PR = 1.39, 95%CI: 1.26 to 1.54; China: PR = 1.49, 95%CI: 1.30 to 1.72) than among men (US: PR = 1.20, 95%CI: 1.04 to 1.38; China: PR = 1.37, 95%CI: 0.94 to 1.98). Conclusions Findings from this study will improve present understanding of heart disease etiology and provide essential insights for future prevention, treatment, and control. Better management of smoking behaviors by gender might be beneficial for reducing the burden of heart disease in both countries and worldwide.

scholarly journals Financial ties between leaders of influential US professional medical associations and industry: cross sectional study

BMJ ◽  
2020 ◽  
pp. m1505 ◽  
Author(s):  
Ray Moynihan ◽  
Loai Albarqouni ◽  
Conrad Nangla ◽  
Adam G Dunn ◽  
Joel Lexchin ◽  
...  
Keyword(s):  
Clinical Oncology ◽  
American Psychiatric Association ◽  
The United States ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Medical Associations ◽  
The Us ◽  
American Society ◽  
Financial Relationships

AbstractObjectiveTo investigate the nature and extent of financial relationships between leaders of influential professional medical associations in the United States and pharmaceutical and device companies.DesignCross sectional study.SettingProfessional associations for the 10 costliest disease areas in the US according to the US Agency for Healthcare Research and Quality. Financial data for association leadership, 2017-19, were obtained from the Open Payments database.Population328 leaders, such as board members, of 10 professional medical associations: American College of Cardiology, Orthopaedic Trauma Association, American Psychiatric Association, Endocrine Society, American College of Rheumatology, American Society of Clinical Oncology, American Thoracic Society, North American Spine Society, Infectious Diseases Society of America, and American College of Physicians.Main outcome measuresProportion of leaders with financial ties to industry in the year of leadership, the four years before and the year after board membership, and the nature and extent of these financial relationships.Results235 of 328 leaders (72%) had financial ties to industry. Among 293 leaders who were medical doctors or doctors of osteopathy, 235 (80%) had ties. Total payments for 2017-19 leadership were almost $130m (£103m; €119m), with a median amount for each leader of $31 805 (interquartile range $1157 to $254 272). General payments, including those for consultancy and hospitality, were $24.8m and research payments were $104.6m—predominantly payments to academic institutions with association leaders named as principle investigators. Variation was great among the associations: median amounts varied from $212 for the American Psychiatric Association leaders to $518 000 for the American Society of Clinical Oncology.ConclusionsFinancial relationships between the leaders of influential US professional medical associations and industry are extensive, although with variation among the associations. The quantum of payments raises questions about independence and integrity, adding weight to calls for policy reform.

Epidemiology of Substance Use Disorders

2020 ◽  
pp. 3-28
Author(s):  
L. Morgan Snell ◽  
Andrew J. Barnes ◽  
Peter Cunningham
Keyword(s):  
The United States ◽  
Opioid Use Disorder ◽  
Opioid Overdose ◽  
Prescription Opioids ◽  
Opioid Epidemic ◽  
Provider Education ◽  
Opioid Use ◽  
Prescribing Practices ◽  
The Us ◽  
Overdose Deaths

Nearly 3 million Americans have a current or previous opioid use disorder, and recent data indicate that 10.2% of US adults have ever misused pain relievers. In 2015, approximately 800,000 individuals used heroin, while 4 million misused prescription opioids. Although use of other drugs such as alcohol and cannabis is more prevalent, opioid use contributes to significant morbidity, mortality, and social and economic costs. While the current US opioid overdose epidemic began with prescription opioids, since 2015, heroin and synthetic opioids (e.g., fentanyl) have driven continued increases in opioid overdose deaths, contributing to a recent decline in overall life expectancy in the United States. Policies to address the opioid epidemic by changing clinical practice include provider education, monitoring prescribing practices, and expanding the clinical workforce necessary to treat opioid use disorders. The opioid epidemic appears to be largely a US phenomenon and a consequence of both structural challenges in the US healthcare system and growing socioeconomic disparities, and thus it will require policies including and beyond delivery system reforms to resolve it.

scholarly journals Youth Single-Sport Specialization in Professional Baseball Players

2020 ◽  
Vol 8 (3) ◽  
pp. 232596712090787
Author(s):  
Patrick S. Buckley ◽  
Michael C. Ciccotti ◽  
Meghan Bishop ◽  
Patrick Kane ◽  
Stephen Selverian ◽  
...  
Keyword(s):  
Athletic Trainers ◽  
The United States ◽  
Cross Sectional Study ◽  
Professional Baseball ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Baseball Players ◽  
Current Trends ◽  
Youth Baseball ◽  
The Us

Background: An increasing number of youth baseball athletes are specializing in playing baseball at younger ages. Purpose: The purpose of our study was to describe the age and prevalence of single-sport specialization in a cohort of current professional baseball athletes. In addition, we sought to understand the trends surrounding single-sport specialization in professional baseball players raised within and outside the United States (US). Study Design: Cross-sectional study; Level of evidence, 3. Methods: A survey was distributed to male professional baseball athletes via individual team athletic trainers. Athletes were asked if and at what age they had chosen to specialize in playing baseball at the exclusion of other sports, and data were then collected pertaining to this decision. We analyzed the rate and age of specialization, the reasons for specialization, and the athlete’s perception of injuries related to specialization. Results: A total of 1673 professional baseball athletes completed the survey, representing 26 of the 30 Major League Baseball (MLB) organizations. Less than half (44.5%) of professional athletes specialized in playing a single sport during their childhood/adolescence. Those who reported specializing in their youth did so at a mean age of 14.09 ± 2.79 years. MLB players who grew up outside the US specialized at a significantly earlier age than MLB players native to the US (12.30 ± 3.07 vs 14.89 ± 2.24 years, respectively; P < .001). Additionally, MLB players raised in the US recalled a significantly higher incidence of sustaining an injury attributed to specializing in baseball than MLB athletes raised outside the US (27.7% vs 20.6%, respectively; P = .05). Conclusion: This study challenges the current trends toward early youth sport specialization, finding that the majority of professional baseball athletes studied did not specialize as youth and that those who did specialize did so at a mean age of 14 years. With the potential cumulative effects of pitching and overhead throwing on an athlete’s arm, the trend identified in this study toward earlier specialization within baseball is concerning.

scholarly journals Epidemiological Profiles of Foreign-Born and US-Born Hispanic Blood Donors in a Major Metropolitan Area in the United States

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Adelbert B. James ◽  
Cassandra D. Josephson ◽  
Marta I. Castillejo ◽  
George B. Schreiber ◽  
John D. Roback
Keyword(s):  
Blood Donors ◽  
Blood Donation ◽  
The United States ◽  
Cross Sectional Study ◽  
Foreign Born ◽  
Rates Of Return ◽  
Cross Sectional ◽  
Major Metropolitan Area ◽  
The Us ◽  
Donated Blood

Background. The explosive growth of Hispanics in the US makes this population a significant and untapped source for blood donation. Methods. A cross-sectional study was performed to evaluate blood donation behaviors and demographics of foreign-born and US-born Hispanic donors between 2006 and 2009 in metropolitan Atlanta, GA, USA. Bivariate analyses and multivariate logistic regression were used to assess factors associated with foreign-born donors. Results. 5,119 foreign-born and 11,841 US-born Hispanics donated blood. Foreign-born Hispanic donors were more likely than US-born donors to be blood group O (57.6% versus 52.0%; P<.001) and more frequent donors (2.2 versus 2.0; P<.001). Cuban-born donors had the highest rates of return donation (63.2%). In contrast, Mexicans, the most prevalent subpopulation among foreign-born Hispanic donors (31.8%), had the lowest rates of return donation (42.0%). Conclusions. The heterogeneity found among Hispanic donors in this study is valuable for the design of recruitment strategies to increase blood donations.

scholarly journals 221. Comparison of dental antibiotic prescribing between Australia, England, the United States and British Columbia in 2017

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S112-S112
Author(s):  
Leanne Teoh ◽  
Wendy Thompson ◽  
Colin Hubbard ◽  
David M Patrick ◽  
Fawziah Marra ◽  
...  
Keyword(s):  
United States ◽  
British Columbia ◽  
Antibiotic Resistance ◽  
Research Training ◽  
The United States ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Cross Sectional ◽  
Public Health Burden

Abstract Background Antibiotic resistance is recognised as a major public health burden. Dentists overprescribe antibiotics and prescribe for unnecessary indications. Tracking and investigating prescribing practices by healthcare professionals provides insights needed to inform targeted antibiotic stewardship interventions. It is unclear how dental antibiotic prescribing patterns differs between countries. The aim of this study was to compare antibiotic prescribing by dentists in Australia, England the United States (US) and British Columbia (BC). Methods This was a cross-sectional study of dispensed dental antibiotic prescriptions between January 1 and December 31, 2017, from Australia, England, US and BC. Dispensed dental antibiotic prescriptions included those from outpatient pharmacies and healthcare settings. Outcome measures included the proportion of dental antibiotic prescriptions by location and prescribing rates by population. Results English dentists prescribed 1.6 times more antibiotics than those in Australia, and dentists in BC and US prescribed around twice more than Australian dentists. (Australia: 33.2 prescriptions/1000population; England: 53.5 prescriptions/1000population; US: 72.6 prescriptions/1000 population; BC: 65.0 prescriptions/1000 population). The types of antibiotics prescribed were similar across all countries, where penicillins were the predominant class prescribed (66.8–80.5% of antibiotic prescriptions). US dentists and dentists in BC prescribed more clindamycin compared to the dentists in other countries. Conclusion Dentists in the US, England and BC prescribed at relatively higher rates than Australian dentists. The findings from this study should initiate an evaluation by dentists of their prescribing practices and responsibilities regarding their contribution towards antibiotic resistance. Further investigations can be aimed at determining country-specific factors that influence dental antibiotic prescription. Disclosures Leanne Teoh, BDSc(Hons) BPharm(Hons), Australian Government Research Training Program Scholarship (Other Financial or Material Support, Scholarship awarded for the PhD candidature)

scholarly journals Professional Life Satisfaction Based on Dimensions of Well-being among Firefighters in South Korea and the United States: A Cross-Sectional Study

2021 ◽  
Author(s):  
Dongwoo Song ◽  
Haejun Park ◽  
Changhoon Bang ◽  
Sohee Kim ◽  
Jaehong Kim
Keyword(s):  
Life Satisfaction ◽  
South Korea ◽  
Working Hours ◽  
Well Being ◽  
The United States ◽  
Cross Sectional Study ◽  
Job Skills ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Us

Upgrading firefighters’ life satisfaction can enhance their job skills, and contribute to their safety and that of the public. This study’s purpose was to identify general life satisfaction levels and national characteristics, including firefighters’ occupational issues in Korea and the US. The final sample sizes in this cross-sectional study were 1,523 for South Korea and 229 for the US. The findings were based on firefighters’ physical/mental health and satisfaction with occupational problems. To measure their life satisfaction, six dimensions were examined: social, spiritual, intellectual, emotional, physical, and occupational. The average satisfaction score of firefighters was 3.50 in Korea and 4.00 in the US. The US showed high satisfaction in most subitems. However, US firefighters showed low satisfaction in the physical context and Korean firefighters in the occupational context. Multiple regression analysis of the variables affecting firefighters’ life satisfaction showed that the occupational dimension was significant in both Korea and the US, and a similar analysis of demographic characteristics as independent variables showed that differences in satisfaction by gender were important in both countries. For Korea, the key variables were in the working hours section; for the US, in the specialty section. The results of this study should make it easier to identify and focus on the relevant areas of firefighters’ working lives in Korea and the US, thereby improving their life satisfaction.

Sign in / Sign up

Export Citation Format

Share Document