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Войти в исследования Asian Pacific journal of cancer prevention : APJCP · 2022
Smokeless Tobacco Use among Pregnant Women in India: The Tale of Two Nationally Representative Surveys.
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Rockwell Michelle S, Grubb Christopher, Turner Jamie K, Vinson Matthew, Yim Isaiah, Hanlon Alexandra L, Epling John W
Аннотация
OBJECTIVES: Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) poses a risk to patients with chronic kidney disease (CKD), heart failure (HF), and hypertension (HTN). We evaluated changes in NSAID utilization among a large cohort of Virginia patients with CKD, HF, and/or HTN during the COVID-19 pandemic and assessed variation by patient demographic characteristics.
STUDY DESIGN: Quasi-experimental difference-in-differences approach.
METHODS: Using claims from the Virginia All-Payer Claims Database, we identified NSAID prescriptions dispensed to patients with CKD, HF, and/or HTN during the years 2019-2021. We applied Poisson regression to assess the impact of the COVID-19 pandemic (March 1, 2020- December 31, 2021) on NSAID utilization rates, stratifying incidence rate ratios (IRRs) by rurality, sex, and age.
RESULTS: Extrapolated to the statewide population, approximately 3.8 million NSAID prescriptions were dispensed to Virginians with CKD, HF, and/or HTN between 2019 and 2021. Utilization rates declined by 23% during the first 2 years of the pandemic, were greater in rural vs urban areas (IRR, 1.594; 95% CI, 1.408-1.803) and among those aged 40 to 64 years, 65 to 79 years, and 80 years and older vs those aged 18 to 39 years (40-64 years: IRR, 6.366; 95% CI, 5.979-6.778; 65-79 years: IRR, 6.980; 95% CI, 6.568-7.417; ≥ 80 years: IRR, 5.223; 95% CI, 4.772-5.715); and were lower among men than women (IRR, 0.779; 95% CI, 0.758-0.800). The pandemic impacted rural and urban areas and women and men similarly but was associated with lower NSAID utilization among the 3 older age groups vs those aged 18 to 39 years (40-64 years: IRR, 0.869; 95% CI, 0.812-0.931; 65-79 years: IRR, 0.788; 95% CI, 0.733-0.847; ≥ 80 years: IRR, 0.769; 95% CI, 0.709-0.833).
CONCLUSIONS: Despite a modest decline during the first 2 years of the pandemic, NSAID use remains prevalent among patients with CKD, HF, and/or HTN, especially in rural areas and among women. Results highlight the need for tailored deprescribing efforts.
STUDY DESIGN: Quasi-experimental difference-in-differences approach.
METHODS: Using claims from the Virginia All-Payer Claims Database, we identified NSAID prescriptions dispensed to patients with CKD, HF, and/or HTN during the years 2019-2021. We applied Poisson regression to assess the impact of the COVID-19 pandemic (March 1, 2020- December 31, 2021) on NSAID utilization rates, stratifying incidence rate ratios (IRRs) by rurality, sex, and age.
RESULTS: Extrapolated to the statewide population, approximately 3.8 million NSAID prescriptions were dispensed to Virginians with CKD, HF, and/or HTN between 2019 and 2021. Utilization rates declined by 23% during the first 2 years of the pandemic, were greater in rural vs urban areas (IRR, 1.594; 95% CI, 1.408-1.803) and among those aged 40 to 64 years, 65 to 79 years, and 80 years and older vs those aged 18 to 39 years (40-64 years: IRR, 6.366; 95% CI, 5.979-6.778; 65-79 years: IRR, 6.980; 95% CI, 6.568-7.417; ≥ 80 years: IRR, 5.223; 95% CI, 4.772-5.715); and were lower among men than women (IRR, 0.779; 95% CI, 0.758-0.800). The pandemic impacted rural and urban areas and women and men similarly but was associated with lower NSAID utilization among the 3 older age groups vs those aged 18 to 39 years (40-64 years: IRR, 0.869; 95% CI, 0.812-0.931; 65-79 years: IRR, 0.788; 95% CI, 0.733-0.847; ≥ 80 years: IRR, 0.769; 95% CI, 0.709-0.833).
CONCLUSIONS: Despite a modest decline during the first 2 years of the pandemic, NSAID use remains prevalent among patients with CKD, HF, and/or HTN, especially in rural areas and among women. Results highlight the need for tailored deprescribing efforts.