American journal of preventive medicine
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Opioid prescription policies may reduce availability of prescription opioids and decrease initiation of opioid analgesic misuse and possible opioid use disorder. Opioid use disorder prevalence may have decreased in recent years, but there are few studies on trends of opioid use disorder incidence. The objective of this study was to examine opioid use disorder incidence rates to detect population changes overall and within demographic subgroups over time. ⋯ This study found that the opioid use disorder incidence rate in Vermont decreased overall between July 2017 (policy start limiting opioid analgesic prescriptions) and December 2021, including during the COVID-19 pandemic, with the most pronounced decrease among adolescents and young adults.
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As perinatal drug overdoses continue to rise, reliable approaches are needed to monitor overdose trends during pregnancy and postpartum. This analysis aimed to determine the sensitivity, specificity, positive predictive value, and negative predictive value of ICD-9/10-CM codes for drug overdose events among people in the MATernaL and Infant clinical NetworK (MAT-LINK) with medication for opioid use disorder during pregnancy. ⋯ The sensitivity and positive predictive value of ICD-9/10-CM codes for capturing drug overdose compared with abstracted electronic health record data during the perinatal period was low in this cohort of people with medication for opioid use disorder during pregnancy, though the specificity and negative predictive value were high. Incorporating other data from electronic health records and outside the healthcare system might provide more comprehensive insights on nonfatal drug overdose in this population.
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Age at diagnosis of diabetes is important for informing public health planning and treatment strategies. This study aimed to estimate trends and racial/ethnic differences in age at diagnosis of adult-onset diabetes by type in the U.S. ⋯ Among U.S. adults, the mean age at diagnosis of adult-onset type 1 diabetes remained stable, and of adult-onset type 2 diabetes increased significantly from 2016 to 2022. Substantial and opposite differences in mean diagnosis age of type 1 diabetes and type 2 diabetes by race/ethnicity were identified.
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Primary care delivery in the United States, including tobacco treatment, was negatively impacted by the COVID-19 public health emergency, leading to pandemic-related cessation disparities. Early in the public health emergency, rates of tobacco assessment during telehealth visits were substantially lower than during in-person visits. It is unknown if these changes persisted. ⋯ Smoking assessment remained consistently lower during the public health emergency compared with the months prior, primarily driven by lack of assessment during telehealth visits. Concerted efforts are needed to ensure that telehealth visits are leveraged to promote equitable smoking assessment and delivery of evidence-based tobacco treatment among a patient population with high rates of tobacco use.
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Intimate partner violence accounts for up to one half of all homicides of women in the U.S. Rates of intimate partner homicide are associated with both race/ethnicity and social determinants of health, but their relative contribution is incompletely understood. ⋯ Racial/ethnic composition of a population does not independently predict its rate of intimate partner homicide when controlling for social determinants of health. Racial/ethnic inequities in intimate partner homicide are largely attributable to structural factors, which may be modifiable through policy changes.