التفاصيل البيبلوغرافية
| العنوان: |
Trends and Trajectories of Gabapentinoid Use and Associations with Subsequent Health Outcomes and Healthcare Expenditures in the United States |
| المؤلفون: |
Zhou, Lili |
| المساهمون: |
Bhattacharjee, Sandipan, Slack, Marion K., Malone, Daniel C., Kwoh, C. Kent, Lo Ciganic, Wei Hsuan Jenny |
| بيانات النشر: |
The University of Arizona. |
| سنة النشر: |
2019 |
| المجموعة: |
The University of Arizona: UA Campus Repository |
| مصطلحات موضوعية: |
Gabapentinoids, healthcare expenditures, health outcomes, opioid, trajectories, trends |
| الوصف: |
Background: Increasing use of gabapentinoids (i.e., gabapentin and pregabalin), especially in off-label use or concurrent use with opioids, has raised concerns of misuse/abuse of gabapentinoids in the United States (US). Little is known about the patient and prescriber characteristics most associated with gabapentinoid use, as well as utilization patterns of gabapentinoids and their associations with subsequent adverse health outcomes and healthcare expenditures in the US. Objectives: This dissertation aimed to examine (1) trends, patient and prescriber characteristics, and potential off-label use of gabapentinoids among the US ambulatory care visits, (2) dual-trajectories of opioid and gabapentinoid use and risk of adverse health outcomes among US Medicare beneficiaries, and (3) association between dual-trajectories of opioid and gabapentinoid use and healthcare expenditures in US Medicare. Methods: This dissertation included the data source from (1) National Ambulatory Medical Care Survey (NAMCS) data from 2003-2015 and (2) 5% national representative sample of Medicare data from 2011-2016. A multivariable logistic regression, group-based multi-trajectory models along with inverse probability of treatment weighted multivariable Cox proportional hazard model and inverse probability of treatment weighted multivariable generalized linear regression, with log link and gamma distribution, were used to examine the three objectives of this dissertation, respectively. Results: This dissertation yielded three important insights into the patterns of gabapentinoid use. First, we found that the ambulatory visits involving gabapentinoids quadrupled from 2003-2015 in US ambulatory settings. Half of the gabapentinoid visits had concurrent opioids and/or benzodiazepine use. Gabapentinoids were mainly prescribed by primary care physicians, and potential off-label use of gabapentinoids was overwhelmingly high. Second, we identified ten distinct dual-trajectories of opioid and gabapentinoid use among fee-for-service Medicare ... |
| نوع الوثيقة: |
doctoral or postdoctoral thesis |
| اللغة: |
English |
| العلاقة: |
http://hdl.handle.net/10150/634225Test |
| الإتاحة: |
http://hdl.handle.net/10150/634225Test |
| حقوق: |
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction, presentation (such as public display or performance) of protected items is prohibited except with permission of the author. |
| رقم الانضمام: |
edsbas.BA00AEFA |
| قاعدة البيانات: |
BASE |
