Estimation of the Prevalence of Delayed Dispensing Among Opioid Prescriptions From US Surgeons and Dentists.

Importance: Dispensing of opioid prescriptions from dentists and surgeons more than 30 days after writing, or delayed dispensing, could be a potential indicator that opioids were used for reasons or during a time frame other than that intended by the prescriber. The prevalence of delayed dispensing is unknown. Whether laws can prevent delayed dispensing by shortening the maximum period between prescription writing and dispensing is also unknown. Objective: To estimate the prevalence of delayed dispensing among opioid prescriptions from surgeons and dentists, assess the maximum period US states allow between controlled substance prescription writing and dispensing, and evaluate whether laws shortening this period decrease delayed dispensing of opioid prescriptions from surgeons and dentists. Design, Setting, and Participants: In this cross-sectional analysis, data from the IQVIA Formulary Impact Analyzer (representing 63% of US prescriptions) were used to identify opioid prescriptions from surgeons and dentists dispensed from 2014 through 2019. Main Outcomes and Measures: Among opioid prescriptions dispensed in 2019, the proportion with delayed dispensing was calculated. Using legal databases, the maximum state-allowed period between controlled substance prescription writing and dispensing as of December 2019 was examined. Using a difference-in-differences design and 2014 to 2019 data, changes in delayed dispensing prevalence were evaluated among opioid prescriptions from surgeons and dentists after a Minnesota law was enacted in July 2019 precluding opioid prescription dispensing more than 30 days after writing. Control states allowed dispensing beyond this period. Results: In 2019, the database included 20 858 413 opioid prescriptions from surgeons and dentists for 14 789 984 patients; 8 582 029 (58.0%) were female. The mean (SD) patient age was 47.1 (19.3) years. Of prescriptions included, 194 452 (0.9%) had delayed dispensing. As of December 2019, the maximum period between drug writing and dispensing was 180 days in 18 and 43 states for Schedule II and III drugs, respectively. Compared with control states, Minnesota's law decreased delayed dispensing prevalence by 0.22 percentage points (95% CI, -0.32 to -0.13 percentage points). Conclusions and Relevance: In this cross-sectional study, 194 452 opioid prescriptions from surgeons and dentists were dispensed more than 30 days after writing. To mitigate any prescription opioid misuse associated with delayed dispensing, policy makers could shorten the maximum period between writing and dispensing of opioid prescriptions from surgeons and dentists.

Influence of the Home Environment on Physical Activity Behaviors in African American Youth.

Background: This study examined the relationships between components of the home environment and physical activity (PA) behaviors among African American adolescents. Methods: A community-based sample of 99 African American parent-child dyads (62% girls; 42% overweight/obese, 15.0 ± 0.2 years) were included in this analysis. The home environment (PA equipment, family support for PA, and internet access) was evaluated using the Health and Environment Survey. Child PA was measured objectively using accelerometry. Data collection occurred between 2014 and 2016. Results: Internet access was associated with 29 fewer minutes of light physical activity [p = 0.011, ß = -29.25 ± 11.28 (95% confidence interval: -51.65 to -6.86)], 9 fewer minutes of moderate-to-vigorous physical activity [p = 0.045, ß = -9.10 ± 4.48 (-17.98 to -0.21)], and 38 fewer minutes of total PA (TPA) [p = 0.006, ß = -38.35 ± 13.38 (-65.62 to -11.08)]. Family support was associated with 2 minutes of TPA [p = 0.044, ß = 2.25 ± 1.10 (-1.97 to 3.19)]. PA equipment was not significantly associated with greater PA (all p's > 0.05). Conclusions: These findings suggest that home internet access may hinder participation in PA among African American adolescents. Future research should continue to identify barriers in the home environment that contribute to physical inactivity among African American adolescents.

Trends in the number of patients linked to potential vet-shopping behavior in the United States (2014-2019).

OBJECTIVE: To estimate the number of patients linked to vet-shopping behavior (the solicitation of controlled substance prescriptions from multiple veterinarians for misuse) in the United States using 2014-2019 data and characterize mandates for veterinarians to examine prescription drug monitoring programs (PDMPs) before prescribing controlled substances as of April 2021. SAMPLE: National database reporting prescription dispensing from 92% of US pharmacies from 2014 through 2019. PROCEDURES: The annual number of patients with dispensed prescriptions for opioid analgesics, opioid cough-and-cold medications, or benzodiazepines from ≥ 4 veterinarians was calculated. State veterinary medical associations were contacted for information on veterinarian PDMP use mandates. RESULTS: From 2014 through 2019, the number of patients with prescriptions for any class of controlled substances from ≥ 4 veterinarians tripled from 935 to 2,875 (+207.5%). The number of patients with opioid cough-and-cold medication prescriptions from ≥ 4 veterinarians rose from 150 to 1,348 (+798.9%). The corresponding number for benzodiazepines rose from 185 to 440 (+137.8%). The corresponding number for opioid analgesics peaked at 868 in 2016 before decreasing to 733 in 2019. In April 2021, 10 states mandated veterinarians to examine PDMP records of owners or animals before prescribing controlled substances; 3 mandates excluded benzodiazepines. CLINICAL RELEVANCE: Vet shopping in the US may be increasingly common. Mandates for veterinarians to examine PDMPs before prescribing controlled substances might facilitate detection of this behavior. However, benefits of mandates should be weighed against their potential burden on veterinarians.