Buprenorphine treatment for opioid use disorder (OUD) has more than doubled since 2009. However, current US Food and Drug Administration buprenorphine dosing guidelines are based on studies among people using heroin, prior to the emergence of fentanyl in illicit drug supply. To estimate association between dose time discontinuation during a period widespread availability. This retrospective cohort study used statewide Rhode Island Prescription Monitoring Program data. Participants were...

Nursing home residents continue to experience significant COVID-19 morbidity and mortality (1). On March 29, 2022, the Advisory Committee on Immunization Practices (ACIP) recommended a second mRNA vaccine booster dose for adults aged ≥50 years all immunocompromised persons who had received first ≥4 months earlier.* September 1, ACIP voted recommend bivalent boosters ≥12 completed primary series using monovalent vaccines ≥2 earlier (2). Data effectiveness (VE) in nursing population are...

Importance Head-to-head safety comparisons of the mRNA vaccines for SARS-CoV-2 are needed decision making; however, current evidence generalizes poorly to older adults, lacks sufficient adjustment, and inadequately captures events shortly after vaccination. Additionally, no studies date have explored potential variation in comparative vaccine across subgroups with frailty or an increased risk adverse events, information that would be useful tailoring clinical decisions. Objective To compare...

Introduction Co-administering COVID-19 and influenza vaccines is recommended by public health authorities intended to improve uptake convenience; however, the extent of vaccine co-administration largely unknown. Investigations into are needed describe compliance with newer recommendations identify potential gaps in implementation co-administration. Methods A descriptive, repeated cross-sectional study between September 1, 2021 November 30, (Period 1) 2022 2) was conducted. This included...

Although β-blockers are a mainstay of treatment after acute myocardial infarction (AMI), these medications commonly not prescribed for older nursing home residents AMI, in part owing to concerns about potential functional harms and uncertainty benefit. To study the association AMI with decline, mortality, rehospitalization among long-stay 65 years or older. This cohort from May 1, 2007, March 31, 2010, used national data Minimum Data Set, version 2.0, Medicare Parts A D. Individuals...

Guideline-based management of cardiovascular disease often involves prescribing multiple medications, which contributes to polypharmacy and risk for adverse drug events in older adults. Deprescribing is a potential strategy mitigate these risks. We sought characterize compare clinician perspectives regarding deprescribing medications across three specialties. National cross-sectional survey. Ambulatory. Random sample geriatricians, general internists, cardiologists from the American College...

Vaccine hesitancy persists alongside concerns about the safety of coronavirus disease 2019 (COVID-19) vaccines. We aimed to examine effect COVID-19 vaccination on risk death among US veterans. conducted a target trial emulation estimate and compare up 60 days under two strategies: within 7 enrollment versus no through follow-up. The study cohort included individuals aged ≥18 years enrolled in Veterans Health Administration system eligible receive according guideline recommendations from 1...

Hip fractures are associated with significant morbidity and mortality in the nursing home. Our objective was to describe incidence rate (IR) of hip fracture according age, sex, race a nationwide sample long-stay home residents. Using 2007–2010 Medicare claims data linked Minimum Data Set, we identified 892,837 residents (≥100 days same facility) between May 1, 2007 April 30, 2008. were defined using Part A diagnostic codes (ICD-9). Residents followed from date they became resident until...

Older adults residing in long-term care facilities (LTCFs) are at a high risk of being infected with respiratory viruses, such as influenza and syncytial virus (RSV). Although these infections commonly have many cardiorespiratory sequelae, the national burden influenza- RSV-attributable events remains unknown for multimorbid vulnerable LTCF population. To estimate incidence hospitalizations that were attributable to RSV among residents quantify economic on US health system by estimating...

Introduction Respiratory syncytial virus (RSV) is the leading cause of hospitalization among US infants. Characterizing service utilization during infant RSV hospitalizations may provide important information for prioritizing resources and interventions. Objective The objective this study was to describe procedures services received by infants hospitalized their first episode in season, addition what proportion died hospitalization. Methods In retrospective observational study, we analyzed...

Abstract The coronavirus disease 2019 (COVID-19) pandemic has disproportionately impacted Black nursing home (NH) residents. Alzheimer’s Disease and Related Dementias (ADRD) may exacerbate disparities, however little empirical evidence exists on the degree to which race ADRD intersect impact COVID-19-related outcomes. We conducted a cohort study (April-December 2020) leveraging electronic health records from 12 United States NH corporations. used parametric g-formula obtain standardized...

Background Respiratory syncytial virus (RSV) is the leading cause of infant hospitalization in United States. Understanding healthcare utilization associated with medically attended (MA) RSV lower respiratory tract infection (LRTI) might inform research priorities aimed at reducing RSV-associated pediatric morbidity. We described during acute MA LRTI episodes within a geographically diverse cohort infants Methods created retrospective cohorts born States from July 1, 2016 through February...

ABSTRACT Purpose Hip fractures in older adults cause severe pain that often necessitates opioid use. However, opioids may trigger falls result subsequent fractures. Studies examining the effects of on are limited by unmeasured confounding between opioid‐treated and untreated persons. To overcome this limitation, we used a self‐controlled case series (SCCS) design to investigate fracture risk during periods use after hip fracture. Methods The retrospective cohort included Medicare...

Background Both diabetes and low magnesium‐containing food intake may increase the risk of heart failure (HF). However, effect nonprescription magnesium supplements on HF or major adverse cardiac events in patients with is unknown. Methods Results Using a target‐trial‐emulation approach, we assembled national cohort 94 239 veterans ≥40 years diabetes, without prior use, who received ambulatory care US veterans‐health system documented by electronic clinic notes between January 1, 2006...

Abstract Denosumab is an injectable osteoporosis medication administered twice per year. Discontinuation of denosumab can result in rapid rebound fractures, but evidence limited on real-world persistence to denosumab. We conducted two parallel, population-based cohort studies leveraging: 1) healthcare administrative data from Ontario, Canada (ON; 100% population); and 2) a 20% random sample US Medicare beneficiaries (US). The first claim (US: 1/2010-2012/2019; ON: 1/2012-2012/2021) was...

Strategies used to predict fracture in community-dwellers may not be useful the nursing home (NH). Our objective was develop and validate a model (Fracture Risk Assessment Long-term Care [FRAiL]) 2-year risk of hip NH residents using readily available clinical characteristics. The derivation cohort consisted 419,668 between May 1, 2007 April 30, 2008 fee-for service Medicare. Hip fractures were identified Part A diagnostic codes. Resident characteristics obtained Minimum Data Set D claims....

Objectives To quantify prescription analgesic use of elderly nursing home ( NH ) residents with persistent noncancer pain and to identify individual facility traits associated no treatment. Design Cross‐sectional study. Setting Linked Minimum Data Set MDS assessments; Online Survey, Certification Reporting OSCAR records; Medicare Part D claims. Participants Individuals aged 65 older were identified from a cross‐section all long‐stay U.S. an assessment enrollment in 2008, excluding those who...