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Prescription Drug Abuse Among Patients in Rural Dental Practices Reported by Members of the National Dental PBRN.

ABSTRACT: PURPOSE:This study compared rural to nonrural dentists with respect to opioid prescribing practices, perceptions about prescription drug abuse among patients, and training relevant to pain management and addictions. METHODS:A web-based, cross-sectional questionnaire was administered to practicing dentist members of the National Dental Practice-Based Research Network (PBRN; N = 822) and linked with network enrollment questionnaire data regarding practitioner demographics and practice characteristics. Pain management prescribing practices and perceptions regarding relevance and scope of addiction and drug diversion among patients were assessed. Rural practice was defined as a practice whose ZIP Code has more than 50% of its population in either a nonmetropolitan county and/or a rural Census tract. FINDINGS:Rural dentists were significantly more likely than their nonrural counterparts to recommend nonsteroidal anti-inflammatory agents/acetaminophen in combination with prescribing an opioid [F (1,820) = 4.59, P = .03]. Compared to nonrural dentists, rural dentists were more likely to report that opioid abuse/diversion was a problem in their practices [?2 [1, n = 807] = 6.85, P < .001], were more likely to have suspected a patient of abuse or diversion [?2 [1, n = 807] = 10.12, P = .001], and were more likely to have refrained from prescribing due to suspicions of abuse or diversion [?2 [1, n = 807] = 12.49, P < .001]. CONCLUSION:Rural dentists may be disproportionately impacted by patients' opioid abuse and represent a viable target for educational outreach that encourages screening, identification, and referral of patients in need of drug abuse treatment.

SUBMITTER: McCauley JL

PROVIDER: S-EPMC7002236 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Prescription Drug Abuse Among Patients in Rural Dental Practices Reported by Members of the National Dental PBRN.

McCauley Jenna L JL Nelson Joni D JD Gilbert Gregg H GH Gordan Valeria V Durand Scott H SH Mungia Rahma R Meyerowitz Cyril C Leite Renata S RS Fillingim Roger B RB Brady Kathleen T KT

The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association 20190806 2

<h4>Purpose</h4>This study compared rural to nonrural dentists with respect to opioid prescribing practices, perceptions about prescription drug abuse among patients, and training relevant to pain management and addictions.<h4>Methods</h4>A web-based, cross-sectional questionnaire was administered to practicing dentist members of the National Dental Practice-Based Research Network (PBRN; N = 822) and linked with network enrollment questionnaire data regarding practitioner demographics and practi ...[more]

PMID: 31385367

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Project description:Some patients experience severe pain following root canal therapy (RCT) despite advancements in care. We sought to identify factors, which can be measured preoperatively, that predict this negative outcome so that future research may focus on preemptive steps to reduce postoperative pain intensity. Sixty-two practitioners (46 general dentists and 16 endodontists) who are members of the National Dental Practice-Based Research Network enrolled patients receiving RCT for this prospective observational study. Baseline data collected from patients and dentists were obtained before treatment. Severe postoperative pain was defined based on a rating of ≥7 on a scale from 0 (no pain) to 10 (pain as bad as can be) for the worst pain intensity experienced during the preceding week, and this was collected 1 wk after treatment. Multiple logistic regression analyses were used to develop and validate the model. A total of 708 patients were enrolled during a 6-m period. Pain intensity data were collected 1 wk postoperatively from 652 patients (92.1%), with 19.5% (n = 127) reporting severe pain. In multivariable modeling, baseline factors predicting severe postoperative pain included current pain intensity (odds ratio [OR], 1.15; 95% confidence interval [CI], 1.07 to 1.25; P = 0.0003), number of days in the past week that the subject was kept from their usual activities due to pain (OR, 1.32; 95% CI, 1.13 to 1.55; P = 0.0005), pain made worse by stress (OR, 2.55; 95% CI, 1.22 to 5.35; P = 0.0130), and a diagnosis of symptomatic apical periodontitis (OR, 1.63; 95% CI, 1.01 to 2.64; P = 0.0452). Among the factors that did not contribute to predicting severe postoperative pain were the dentist's specialty training, the patient's age and sex, the type of tooth, the presence of swelling, or other pulpal and apical endodontic diagnoses. Factors measured preoperatively were found to predict severe postoperative pain following RCT. Practitioners could use this information to better inform patients about RCT outcomes and possibly use different treatment strategies to manage their patients (Clinicaltrials.gov NCT01201681).

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Prescription Drug Abuse Among Patients in Rural Dental Practices Reported by Members of the National Dental PBRN.

Publications

Prescription Drug Abuse Among Patients in Rural Dental Practices Reported by Members of the National Dental PBRN.

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