J Am Dent Assoc. 2018 Jun 18. pii: S0002-8177(18)30310-6. doi: 10.1016/j.adaj.2018.04.027. [Epub ahead of print]
Abstract
BACKGROUND:
Gaining
a better understanding of dental prescribing can help identify
opportunities for intervention regarding optimal medication use. The
purpose of this study is to characterize opioid and antibiotic
prescribing patterns of dentists in the United States for Medicare Part D
beneficiaries.
METHODS:
The authors conducted a
retrospective cross-sectional analysis of national 2014 Medicare Part D
Prescriber Public Use File data. Providers in the data set with
dental-related disciplines were included (n = 99,797). Outcomes of
interest were mean days' supply and mean number of claims reported per
claim, beneficiary, and prescriber discipline.
RESULTS:
Of
the 6,724,372 dental prescription claims submitted, 3,947,848 (58.7%)
and 1,312,796 (19.5%) were for antibiotics and opioids, respectively.
Sixty-nine percent of dentists in the highest quartile of opioid
prescribers were also in the highest quartile of antibiotic prescribers
(r
2 = 0.7778; P < .01). The mean (standard deviation)
days' supply per claim was 6.9 (5.3) days (range, 1-90 days) for
antibiotics and 3.6 (2.0) days (range, 1-44.5 days) for opioids. Of the
33,348 dental providers who prescribed opioids, 18,971 (56.9%)
prescribed a mean opioid days per claim greater than the recommended
duration of 3 days for acute pain.
CONCLUSION:
Opioids
and antibiotics are the medications most prescribed by dentists. On the
basis of national recommendations and results of studies from other
countries, the length of therapy prescribed may be excessive. Further
studies should be conducted to assess appropriateness of dental
prescriptions.
PRACTICAL IMPLICATIONS:
Dentistry should be considered for antibiotic and opioid stewardship interventions along with medicine.
Comments