In the United States, prescription opioids have been a major problem that contributed to the opioid crisis in the country. As dentists prescribe analgesics routinely for dental pain management, further investigation into opioid and non-opioid prescription patterns by dentists on a national level is needed. This research project aimed to examine 1) the trends in opioid and non-opioid analgesic prescriptions by dentists in the US,2) to examine the racial-ethnic disparities in receiving an opioid and non-opioid prescription from a dental professional, 3) the effect of federal Rescheduling of hydrocodone combination on opioid prescription patterns by dentists in a school setting. Data on analgesic prescriptions by dentists were obtained using medical panel survey MEPS (1996- 2015), and Boston University Henry M. Goldman School of Dental Medicine clinical repository (2010 -2019). On average about 31,206 individuals of all ages were interviewed for MEPS each year. The trend in analgesics prescription was reported weighted numbers and proportions of total and dental analgesics prescriptions were reported. Kendall tau correlation test was used to examine trends in the rate of opioid prescriptions per 100 persons over survey years. Racial differences were examined using MEPS data (2002-2015) on dental analgesic prescriptions, dental care utilization, patients’ race, and other demographic information. The outcome was analgesic prescription received. The main independent variable was the patients’ race/ethnicity. Covariates included in the analysis were gender, age, marital status, income, geographical region, and survey year. Using BUSDM data (2010-2019) we examined 12,807 patients who received an opioid prescription from a dentist. The primary outcome variables were opioid prescriptions and opioid morphine milligram equivalent (MME). The primary predictor used is the date of opioid prescription (Time before and after the intervention). To assess the effect of hydrocodone medication reclassification on the outcome variables we used an interrupted time series (ITS) analysis with a segmented regression model. Our results showed a decrease in the proportion of dental opioids out of total opioids from 9.76% in 1996 to 4.5% in 2015. Kendall tau correlation indicated an increase in prescribing rate over the years in total opioids but not in dental opioids. Racial differences were found in opioid prescriptions by dentists with whites having a lower risk of receiving an opioid analgesic compared to other racial minorities. The effect of federal rescheduling of hydrocodone combination on opioid prescription patterns by dentists showed specifically a reduction in non-hydrocodone opioids prescribing rate by morphine milligram equivalent (MME). In conclusion dentists’ contribution to the increase in prescription opioids in the United States seem to be limited compared to other health care professionals. Nevertheless, racial differences were found in whites when compared to other racial minorities. Efforts to curb the use of opioids should be encouraged even more so with evidence supporting the effectiveness of non-opioids analgesics in control of dental pain. / 2022-12-09T00:00:00Z
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/41792 |
| Date | 09 December 2020 |
| Creators | Alofi, Adeem S. |
| Contributors | Singhal, Astha |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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