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Trends and racial/ethnic disparities in antibiotic prescribing practices of dentists in the United States.

ABSTRACT: OBJECTIVE:The aim of this study was to examine trends and racial/ethnic disparities in antibiotic prescribing practices of dentists in the United States. METHODS:The US Medical Expenditure Panel Survey data for 1996-2013 was analyzed. Information on patient sociodemographic characteristics, dental visits, receipt of dental procedures, and type of antibiotics prescribed following visits was obtained. Descriptive statistics were calculated separately for each year. Logistic regression analyses were conducted to identify associations during the period with and without adjustment for dental procedures and sociodemographic characteristics. Survey weights were incorporated to handle the sampling design. RESULTS:Nationally, the number of antibiotic prescribed at dental visits was estimated to be higher by 842,749 (0.4 percent) at year 2013 compared to the prescription level at 2003 were the population sociodemographic distribution kept at 2013 level. On average, the odds of prescribing antibiotics following dental care increased with each decade of study (OR: 1.10; 95% CI: [1.04, 1.17]) after adjusting for sociodemographic characteristics and receipt of dental procedures. Compared to Whites, Blacks had 21 percent (95% CI: 11%, 31%) higher odds of receiving a prescription for antibiotics from a dentist after adjusting for dental procedure and other sociodemographic characteristics. CONCLUSIONS:The prescription of antibiotics following dental visits increased over time after adjustment for sociodemographic characteristics and dental procedure. The probability of being prescribed antibiotics by dentists was higher for Blacks compared to Whites.

SUBMITTER: Okunseri C

PROVIDER: S-EPMC5832582 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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Trends and racial/ethnic disparities in antibiotic prescribing practices of dentists in the United States.

Okunseri Christopher C Zheng Cheng C Steinmetz Cory Neil CN Okunseri Elaye E Szabo Aniko A

Journal of public health dentistry 20170830 2

<h4>Objective</h4>The aim of this study was to examine trends and racial/ethnic disparities in antibiotic prescribing practices of dentists in the United States.<h4>Methods</h4>The US Medical Expenditure Panel Survey data for 1996-2013 was analyzed. Information on patient sociodemographic characteristics, dental visits, receipt of dental procedures, and type of antibiotics prescribed following visits was obtained. Descriptive statistics were calculated separately for each year. Logistic regressi ...[more]

PMID: 28857224

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Project description:BackgroundAccurate forecasting of cardiovascular disease mortality is crucial to guide policy and programming efforts. Prior forecasts often have not incorporated past trends in rates of reduction in cardiovascular disease mortality. This creates uncertainties about future trends in cardiovascular disease mortality and disparities.Methods and resultsTo forecast US cardiovascular disease mortality and disparities to 2030, we developed a hierarchical bayesian model to determine and incorporate prior age, period, and cohort effects from 1979 to 2012, stratified by age, sex, and race, which we combined with expected demographic shifts to 2030. Data sources included the National Vital Statistics System, Surveillance, Epidemiology, and End Results (SEER) single-year population estimates, and US Bureau of Statistics 2012 national population projections. We projected coronary disease and stroke deaths to 2030, first on the basis of constant age, period, and cohort effects at 2012 values, as is most commonly done (conventional), and then with the use of more rigorous projections incorporating expected trends in age, period, and cohort effects (trend based). We primarily evaluated absolute mortality. The conventional model projected total coronary and stroke deaths by 2030 to increase by ≈18% (67 000 additional coronary deaths per year) and 50% (64 000 additional stroke deaths per year). Conversely, the trend-based model projected that coronary mortality would decrease by 2030 by ≈27% (79 000 fewer deaths per year) and stroke mortality would remain unchanged (200 fewer deaths per year). Health disparities will be improved in stroke deaths but not coronary deaths.ConclusionsAfter prior mortality trends and expected demographic shifts are accounted for, total US coronary deaths are expected to decline, whereas stroke mortality will remain relatively constant. Health disparities in stroke but not coronary deaths will be improved but not eliminated. These age, period, and cohort approaches offer more plausible predictions than conventional estimates.

Project description:BACKGROUND:The purpose of this study was to assess dental antibiotic prescribing trends over time, to quantify the number and types of antibiotics dentists prescribe inappropriately, and to estimate the excess health care costs of inappropriate antibiotic prescribing with the use of a large cohort of general dentists in the United States. METHODS:We used a quasi-Poisson regression model to analyze antibiotic prescriptions trends by general dentists between January 1, 2013, and December 31, 2015, with the use of data from Express Scripts Holding Company, a large pharmacy benefits manager. We evaluated antibiotic duration and appropriateness for general dentists. Appropriateness was evaluated by reviewing the antibiotic prescribed and the duration of the prescription. RESULTS:Overall, the number and rate of antibiotic prescriptions prescribed by general dentists remained stable in our cohort. During the 3-year study period, approximately 14% of antibiotic prescriptions were deemed inappropriate, based on the antibiotic prescribed, antibiotic treatment duration, or both indicators. The quasi-Poisson regression model, which adjusted for number of beneficiaries covered, revealed a small but statistically significant decrease in the monthly rate of inappropriate antibiotic prescriptions by 0.32% (95% confidence interval, 0.14% to 0.50%; P = .001). CONCLUSIONS:Overall antibiotic prescribing practices among general dentists in this cohort remained stable over time. The rate of inappropriate antibiotic prescriptions by general dentists decreased slightly over time. PRACTICAL IMPLICATIONS:From these authors' definition of appropriate antibiotic prescription choice and duration, inappropriate antibiotic prescriptions are common (14% of all antibiotic prescriptions) among general dentists. Further analyses with the use of chart review, administrative data sets, or other approaches are needed to better evaluate antibiotic prescribing practices among dentists.

Project description:IntroductionDetailed evaluations of racial and ethnic trends and disparities in NSCLC outcomes are lacking, and it remains unclear whether recent advances in screening and targeted therapies for NSCLC have benefited all population groups equally.MethodsUsing the Surveillance, Epidemiology, and End Results 18-registry data, we evaluated trends in overall and stage-specific NSCLC incidence (2007-2018) among patients aged 55 to 79 years by sex and race and ethnicity. Overall and stage-specific 2-year cause-specific survival rates were calculated by sex and race and ethnicity. Health Disparities software calculated absolute (difference) and relative (ratio) disparity measures comparing racial and ethnic groups with the highest and lowest rates (range measures) and comparing white patients (reference group) with other groups (pairwise rate measures). Joinpoint software assessed changes in rates and disparities.ResultsBoth men and women experienced substantial declines in NSCLC incidence from 2007 to 2018, largely due to significant declines in the incidence of distant-stage NSCLC over the study period (p < 0.05). During the same time period, the incidence of local-stage NSCLC significantly increased among black and Hispanic women (p < 0.05) and remained stable among all other groups. Overall, 2-year cause-specific survival rates improved across most racial and ethnic groups, especially among those diagnosed in regional and distant stages. For both sexes, absolute disparities in overall and stage-specific incidence of NSCLC significantly decreased over time (p < 0.05), whereas relative disparities remained unchanged. Pairwise comparison revealed persistent disparities in NSCLC burden between black and white men.ConclusionWe found evidence of narrowing racial and ethnic disparities in NSCLC incidence over time; however, important disparities persist. More work is needed to ensure consistent and equitable access to high-quality screening, diagnosis, and treatment to reduce and eliminate cancer disparities.

Dataset Information

Trends and racial/ethnic disparities in antibiotic prescribing practices of dentists in the United States.

Publications

Trends and racial/ethnic disparities in antibiotic prescribing practices of dentists in the United States.

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