Digital Commons Network^™

Shaping The Future Of Human Biomonitoring (Hbm), Maryam Zare Jeddi, Nancy B. Hopf, Karen S. Galea, Kate Jones, Henriqueta Louro, Maria João Silva, Adrian Covaci, Tiina Santonen, Paul T.J. Scheepers, Susana Viegas, Lesliam Quirós-Alcalá, Asif Qureshi, M. Elizabeth Marder, Natalie Von Goetz, Konstantinos M. Kasiotis, Kyriaki Machera, Ovnair Sepai, Radu Corneliu Duca, Manosij Ghosh, An Van Nieuwenhuyse, Ming Kei Chung, Jihyon Kil, Shoji F. Nakayama, Aziza Menouni, Kaoutar Chbihi, Ana Maria Vekic, Gustavo Souza, Maisarah Nasution Waras

Epidemiology and Environmental Health Faculty Publications

Human biomonitoring (HBM) continues to play an indispensable role within exposure science, offering insights into aggregate chemical exposures across populations and life stages. Since 2018, the European chapter of the International Society of Exposure Science Human Biomonitoring Working Group (ISES Europe HBM WG) has aimed to facilitate generation of more and high-quality HBM data. The working group aims to strengthen integration of HBM data into regulatory frameworks through improved study design, harmonized methodologies, and enhanced reporting practices. Key achievements in the past seven years include the harmonization of HBM metadata through development of minimum information requirements for HBM (MIR-HBM), development …

Association Between Educational Attainment And Discharge Disposition Following Incident Stroke Hospitalization, Ning Li, Erin L. Abner, Silvia Koton, Lena Mathews, Kunihiro Matsushita, Anna Kucharska-Newton

Epidemiology and Environmental Health Faculty Publications

Background – The relationship between educational attainment and discharge disposition after stroke hospitalization remains unclear. This study examined whether educational attainment is associated with discharge disposition after incident stroke and whether stroke severity modifies this association. Methods – The study included Atherosclerosis Risk in Communities (ARIC) participants with an incident stroke hospitalization from 1991 to 2020 who were enrolled in fee-for-service (FFS) Medicare at discharge. Discharge disposition was obtained from hospitalization claims. Educational attainment was categorized as “less than high school” vs. “high school or more.” Multivariable logistic regression models were used to estimate associations between educational attainment and discharge …

Building The Ryan White Hiv/Aids Program Bench In Kentucky, Lauren Bifulco, Kathleen Harding, Jana Collins, Anna Rogers, Lenon Farkash, Marwan Haddad, Alice Thornton

Epidemiology and Environmental Health Faculty Publications

The Ryan White HIV/AIDS program (RWHAP) is governed by legislative and programmatic guidelines that ensure comprehensive services are provided to persons with HIV (PWH) across the United States. Comprehensive training and skill building opportunities for programmatic staff are rare. RWHAP funding recipient organizations may struggle to acquire and retain essential program-specific knowledge, with downstream impact on patient care and treatment. We designed a comprehensive 11-session videoconference learning series to improve program staff’s confidence and competence with RWHAP fundamentals. Quantitative pre-vs-post session data were analyzed using Wilcoxon Signed-Rank tests, and qualitative data using thematic analysis. We enrolled 136 staff from 23 …

Decreased Gabapentin Prescription Fills Among Medicaid Enrollees Following State-Level Schedule V Controlled Substance Classification In Kentucky And West Virginia, Katherine Gora Combs, Stephen W. Marshall, Rachel Vickers-Smith, Alan Kinlaw, Nabarun Dasgupta, Juan M. Hincapie-Castillo

Epidemiology and Environmental Health Faculty Publications

Background: Driven by concerns of gabapentin misuse and other harms, Kentucky (KY) and West Virginia (WV) became the first states to classify gabapentin as a schedule V controlled substance in July 2017 and June 2018, respectively. This study examined the association of these policies with gabapentin utilization among Medicaid beneficiaries. Methods: Using a controlled interrupted time series design, we modeled a segmented generalized least squares regression and calculated the immediate and trend changes of gabapentin prescriptions among Medicaid enrollees in 2 states (KY, WV), separately. North Carolina (NC) was used as a control to account for secular changes; there was …

Nutrient-Driven Transcription Factor-Dna Interactions And Their Signaling Mechanisms In Metabolic Disease, Evelyn A. Bates

Theses and Dissertations--Nutritional Sciences

Metabolic homeostasis is maintained through tightly coordinated signaling networks that integrate diverse physiological inputs. Central to this regulation are transcription factors, which sense nutrient, hormonal, and vitamin-derived signals and translate them into coordinated gene expression programs. Transcription factor activity is governed by DNA binding, recruitment of coregulatory proteins, and interactions with specific response elements in gene promoters, which allows them to selectively modulate diverse metabolic pathways. Owing to their multifactorial and tunable nature, transcription factors have emerged as promising targets for the treatment and diagnosis of metabolic diseases, including metabolic dysfunction-associated steatotic liver disease (MASLD). This dissertation explores the molecular …

Autologous Peripheral Nerve Tissue Grafts Implanted Into The Nucleus Basalis Of Meynert And Substantia Nigra At The Time Of Bilateral Deep Brain Stimulation In Parkinson Disease: A Report Of 2 Cases, Samuel R. Daly, Jorge E. Quintero, Lisa M. Koehl, Elizabeth Roslyn Wallace, Zain Guduru, Julie A. Gurwell, Tripp Hines, Jaimie Hixson, Saad Hulou, John T. Slevin, Frederick A. Schmitt, Greg A. Gerhardt, Craig G. Van Horne

Neurosurgery Faculty Publications

Background and Objectives: Cholinergic degeneration in the nucleus basalis of Meynert (NBM) is implicated in the cognitive impairment seen in Parkinson disease (PD) and is being examined as a potential therapeutic target. We have previously shown the safety of delivering investigational autologous cell-based therapy, ie, peripheral nerve tissue (PNT), to the substantia nigra (SN) at the time of deep brain stimulation (DBS) surgery in PD (DBS-Plus). In this study, we assessed the safety and feasibility of simultaneously delivering that PNT to both the NBM and SN at the time of DBS.

Methods: Two patients with idiopathic PD and mild cognitive …

Changes In Telehealth Usage Among Medicaid Beneficiaries With Mental Illnesses In A Rural State: An Analysis Of Kentucky Medicaid Dataset Over 5 Years (2018–2022), Chizimuzo T.C. Okoli, Tianyi Wang, Bassema Abufarsakh, Sarret Seng, Zainab Almogheer, Jarrah Al-Kayed, Pooja Bhattarai, Holly Stith, Andrew Makowski

Nursing Faculty Publications

Introduction: Accessing mental health care remains challenging for Medicaid beneficiaries with mental illnesses (MI) in rural settings. The COVID-19 pandemic prompted telehealth service expansion through temporary policy changes and shifts in health care delivery. Despite the increased availability of telehealth as a modality to address disparities in health care access, telehealth adoption and associated use are inadequately explored among Medicaid beneficiaries with MI in Kentucky.

Objective: To examine trends and factors associated with telehealth use by residence status among Kentucky Medicaid beneficiaries with MI.

Design: A retrospective analysis of Kentucky Medicaid claims data obtained from 174,354 beneficiaries aged 18 years …

Cannabis Retail Environment And Treatment For Cannabis Use Disorder, Jeremy Mennis, J. Douglas Coatsworth, Nikola Zaharakis, Nathaniel R. Riggs, Aaron Brown

Social Work Faculty Publications

Purpose: This research investigates whether the efficacy of a digital cannabis use disorder (CUD) treatment for young adults (age 18–25) differs by exposure to cannabis retailers in the residential neighborhood and activity space (significant places visited throughout daily life).

Methods: This is a secondary analysis of data from a randomized clinical trial of the digital substance use disorder treatment Peer Network Counseling-txt (PNC-txt) for reducing cannabis use among young adults with CUD ( n = 425). We hypothesize that the indirect effect of treatment on reducing cannabis use via the mediating mechanism readiness-to-change is moderated by exposure to cannabis retailers, …

Perceived Adolescent Insecure Attachment With Mothers And Fathers, Helena Pipová, Martin Dolejš, Jaroslava Suchá, Alexander T. Vazsonyi

Sociology Faculty Publications

The aim of this study was to test relationships between adolescent insecure attachment (anxious and avoidant) with mothers and fathers and three outcomes: food addiction, eating disorders, and weight status, in a large multi-regional sample of Czech adolescents. Anonymous, self-reported data were collected from 3,677 adolescents (1,688 boys, 45.9% and 1,989 girls, 54.1%). Both anxious and avoidant attachment with mothers were positively associated with food addiction (p <.001) and eating-disorder risk (p <.001). Importantly, avoidant attachment with fathers uniquely and additively explained variance in both food addiction (p <.001) and eating-disorder risk (p =.003), after controlling for maternal attachment. Weight status was unrelated to attachment and was predicted by sex and parental education only. Study findings highlight the salience of insecure attachment with both mothers and fathers for food addiction and eating disorders among adolescents and identify the parental relationship as a key potential preventative strategy.

“Policymakers Need To See This!”, Ramona G. Olvera, Peter Balvanz, Owusua Yamoah, Kesla Klingler, Marisa D. Booty, Sylvia A. Ellison, Amy Farmer, Amy K. Kuntz, Hilary L. Surratt, Carrie B. Oser, Margaret L. Mcgladrey

Sociology Faculty Publications

The use of Photovoice methods to identify and address public health challenges has evolved since this participatory action research method’s inception in the 1990s. However, there is a notable lack of research on the dissemination of Photovoice findings to promote community action and change. This study evaluates audience and Photovoice participants’ experiences of dissemination events presenting the results of 21 Photovoice projects that supplemented the HEALing Communities Study (HCS), a multistate community-based study of strategies to reduce opioid overdose deaths. The Photovoice projects captured the perspectives of people with lived experience of substance use disorder and front-line providers regarding their …

Understanding Resilience In Children In Out-Of-Home Care: Using Person-Centered Health Services Research, Hyeeun K. Shin

Theses and Dissertations--Health Services Research (HSR)

Adverse childhood experiences (ACEs), which refer to exposure to traumatic life events before age 18, and instability in caregiving experiences contribute to poor physical, mental, behavioral, and developmental health outcomes for both children and adults. Previous research shows that these experiences can have negative effects both in the short term and throughout a person’s life. However, children’s strengths, which are the internal and external assets that support their development, can help protect against the impact of ACEs. Effective parenting, positive social support, and self-regulation skills are essential factors that build resilience, helping individuals adapt to challenges that may affect their …

College Student Perceptions Of A Pilot Cooking And Nutrition Education Workshop Through The Lens Of The Social Cognitive Theory: A Qualitative Study, Emma Watras, Amelia Sullivan, Emalee Harrington, Mona Therrien-Genes, Kathryn Yerxa, Makenzie Barr-Porter, Jade Mcnamara

Dietetics and Human Nutrition Faculty Publications

This study qualitatively examined college students' perceptions of a pilot cooking and nutrition workshop, College Cooking Connection (CCC), through the Social Cognitive Theory (SCT) framework. Undergraduate students who attended at least one CCC workshop (N = 29) were invited to a 30 min virtual focus group. A trained moderator guided the discussion to gather perceptions of the program. Themes were identified using thematic analysis with a directive and deductive approach based on SCT. Focus groups revealed eight major themes across the SCT. Cognitive themes included: (1) improved nutrition literacy, (2) understanding the nutrition-mental health connection, and (3) increased awareness of …

Do Magnesium Ions Have Similar Effects As Calcium Ions On Resting Membrane Potential?, Anthony Hana, Youngwoo Kim, Joy Bidros, Katie Neglia, Robin L. Cooper

Biology Faculty Publications

Maintaining a membrane electrical potential of biological cells is a dynamic process, as some cells have a continually changing potential, like pacemaker cells, while other cells may function with large or small changes in the membrane potential. Additionally, some cells may change their electrical potential when stimulated or inhibited by electrical signals, chemical compounds, or both—either simultaneously or episodically. The persistent leak of K⁺ through two-pore-domain potassium channels (K2P) and of Na⁺ through Na⁺ leak channels (NALCNs) and the action of pumps and exchangers are primarily responsible for maintaining a resting potential. Ca²⁺ ions are known …

Exogenous Estradiol Does Not Regulate Daily Metabolic Rhythms Underlying Diet-Induced Obesity In Male Mice, W. Brad Osborne, Oliver Vöcking, Victoria Alvord, Oluwabukola Omotola, Yuriko Katsumata, Julie S. Pendergast

Biology Faculty Publications

Male mice fed high-fat diet become obese, but female mice are resistant to diet-induced weight gain. We previously found that circulating estradiol in females protects their daily rhythms from disruption by high-fat feeding to prevent diet-induced obesity. The goal of this study was to determine the effects of estradiol on daily metabolic rhythms in male mice. Male C57BL/6J mice were treated with estradiol and fed high-fat diet for 2 weeks. We measured the effects of high-fat diet feeding on daily rhythms of eating behavior and locomotor activity, and on the phases, or timing, of circadian rhythms in central and peripheral …

Drinking Microstructure Analysis Of Direct Controls Of Water Intake In Male And Female Rats, Bo W. Sortman, Emalie L. Mullane, Kennedy L. Lamb, Andrea A. Edwards, Ann-Marie Torregrossa, Derek Daniels, Jessica Santollo

Biology Faculty Publications

Measures of rodent drinking (lick) patterns are used to test how various manipulations affect fluid intake. Decades of research indicate that manipulating the satiating potency of a stimulus affects the number of licking bursts whereas manipulating the hedonic value of the solution affects the size of the licking bursts or rate of licking. This type of analysis has been largely applied to manipulations that modulate drinking that is already occurring (i.e., indirect controls or modulators of intake), but there is a dearth of studies with detailed measures of licking due to stimuli that are primary drivers of intake which happen …

Expressing Experiences Of Being Gender Non-Conforming In The “Ladies” Restroom Through Autoethnography-Based Research Poetics, Ellen D.B. Riggle

Gender and Women's Studies Faculty Publications

Three research poems are created as an autoethnographic response to feedback on a research article on the author’s experiences as a gender non-conforming person in women’s public restrooms. The feedback loop includes the sharing of lived experiences by others and theoretical (why?) discussions in the context of the gendered policing and politicalization of women’s restrooms. The first found poem includes words, phrases, and descriptions of images used to label spaces designated as women’s restrooms. The second prose poem recounts the author's experiences through a reframing of risk to women’s health, understanding the cultural context of male entitlement and White supremacy, …

Legal Professional Identity Development: An Exploration Of The Social And Emotional Processes By Which Law Students Transition From Novices To Professionals, David Hall Abney Ii

Theses and Dissertations--Communication

This dissertation seeks to heed the call for expansion of instructional communication research (ICR) beyond the undergraduate classroom and undergraduate learning objectives by exploring older learners and higher-order affective learning objectives. Legal professional identity development (LPID) is a discipline-specific type of higher-order affective learning that is conceptualized as a continuous nonlinear process that begins in law school and extends throughout a lawyer’s career, involving the internalization of the legal profession’s core values and norms and their integration with an evolving identity. Using a pragmatic ICR approach and a mixed-methods design, Phase 1 employed individual interviews and focus groups to investigate …

Can Love Bloom On A Battlefield: An Analysis Of Queer Militaristic Fanfiction, Brandon Bost

Theses and Dissertations--Communication

It is noted that readers and fans hold unique and valid interpretations of texts, interpretations that become expressed in fan works like fan art, memes, or the subject of this study, fanfiction. This study performs textual analysis on queer fanfiction in Metal Gear Solid and Code Geass fandoms. It examines the unique relationship militarism holds with intimacy, and how intimacy intersects with violence and control in unique ways in these fan texts. Within these fanfics, militarism can serve as a barrier to intimacy, forcing relationships to adapt to militaristic structures within these fan interpretations.

Exploring The Relationship Between Self-Esteem And Communication Among Equestrians In Facebook Groups, Jenna Young

Theses and Dissertations--Communication

People’s interpersonal relationships and social groups are connected to their self-esteem. Equestrians, a social group unified around riding or working with horses, form identities based on their involvement in the equine industry, whether that be recreationally or professionally. Equestrians’ subjective views of self-esteem may be related to their overall well-being. Theories related to self-esteem and identity indicate that communication within social relationships, like within the equine industry, may impact an individuals’ sense of self-worth. Facebook groups have increased in popularity in the equine industry due to the ease of communication between equestrians. Therefore, this study investigated the relationship between self-esteem …

Conflict Management In Heterosexual Romantic Relationships: A Cognitive Dissonance Perspective, Benjamin Grissom

Theses and Dissertations--Communication

This paper examines how cognitive dissonance corresponds with conflict management strategies in heterosexual romantic relationships from the perspective of romantic partners. The paper synthesizes current findings on how conflicting beliefs and attitudes impact partners' approaches to handling disagreements. Patterns are identified in how cognitive dissonance co-occurs with competition, avoidance, accommodation, compromise, and collaboration. Findings suggest that the discomfort arising from holding conflicting cognitions corresponds to their conflict management approaches depending on the degree of discomfort. Additionally, relationship length is examined as a moderator of the connection between cognitive dissonance and conflict management. Understanding these perceptions can provide insights into enhancing …

Students As Information Responders – Extending Our Understanding Of Students At A Pwi, Anyiah S. Chambers

Theses and Dissertations--Communication

As school shootings continue to rise across the United States, understanding how students respond to and share information during crises has become a critical concern for higher education institutions. While prior research has examined the role of students as first information responders (FIRs) during emergencies, few studies have investigated how these processes unfold among Black and non-Black students at predominantly white institutions (PWIs). This mixed methods study is a replication and extension of Omilion-Hodges and Edwards (2021), examining how undergraduate Black and non-Black students at PWIs evaluate, construct, and disseminate crisis-related messages, particularly during active-shooter events. Grounded in channel specification …

Addressing Obesity And Diabetes In Appalachian Kentucky, Hannah E. Orens

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Type 2 diabetes and obesity are major public health concerns in Appalachian Kentucky. Populations in this region experience much higher rates of chronic disease than the rest of the state, have limited access to preventive care, and ongoing economic challenges that affect health. Many rural counties face increased poverty, transportation challenges, and shortages of healthcare professionals, all of which contributed to poor health outcomes and reduced access to evidence-based prevention programs. As a result, there is a strong need for focused, feasible, community-based interventions that improve access to evidence-based prevention while addressing the social and economic factors influencing health in …

Purchasing A Healthier Future: A Nutrition-Focused, Community-Centered Approach To Reduce Obesity And Diabetes In Graves County, Kentucky, Marissa Stephens

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Obesity and type 2 diabetes are among the most significant public health challenges in the United States, with Kentucky consistently ranking among the states with the highest prevalence of both conditions. Together, these conditions contribute to reduced quality of life, rising healthcare costs, and increased morbidity and mortality, underscoring the need for targeted, community-centered interventions. The disease burden of obesity and diabetes is particularly pronounced in rural areas, including the state’s westernmost region, the Jackson Purchase. Among rural populations, chronic disease risk is driven by a combination of factors, including low socioeconomic status, limited access to healthcare/supermarket options, and food …

Automated Object Detection And Change Quantification In Underground Mines Using Lidar Point Clouds And 360◦ Image Processing, Ana Fabiola Patricia Tejada Peralta, Roya Bakzadeh, Sina Siahidouzazar, Pedram Roghanchi

Mining Engineering Faculty Publications

Underground mining environments pose significant challenges for automated hazard detection due to low illumination, restricted visibility, and the absence of Global Navigation Satellite System (GNSS) coverage. These factors limit situational awareness and delay inspection efforts, particularly after disruptive events when rapid assessment is essential for safety. This study addresses this problem by developing a dual-pipeline framework for 2D–3D detection that uses 360° imaging and LiDAR-based machine learning to identify people, vehicles, and positional changes in underground settings without requiring personnel to re-enter hazardous areas. The objective was to create a system capable of recognizing objects and monitoring spatial changes under …

Building Public Health Data Dashboards: Tutorial Playbook, Elwin Wu, Raymond Balise, Benjamin Katz, Daniel R. Harris, Matthew Bullard, Naleef Fareed, Marc Larochelle, Jennifer Villani

Institute for Biomedical Informatics Faculty Publications

Public health data dashboards have substantial potential to improve transparency, understanding, and decision-making at multiple levels, from individuals to public health practitioners and policymakers. However, creating effective dashboards presents many challenges. In this case-based tutorial on public health dashboard development, we share lessons learned from our experience developing data dashboards for the HEALing Communities Study (HCS), a National Institutes of Health (NIH)–funded, community-engaged intervention to deploy evidence-based practices to reduce opioid overdose deaths in 67 communities across 4 states. We present key decision points dashboard teams must address, along with the major considerations and trade-offs that shaped our approach. First, …

Chronic Alcohol Consumption Enhances The Differentiation Capacity Of Hematopoietic Stem And Progenitor Cells Into Osteoclast Precursors, Hami Hemati, Madison B. Blanton, Jude Koura, Rupak Khadka, Kathleen A. Grant, Ilhem Messaoudi

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Chronic alcohol consumption (CAC) is associated with an enhanced risk of bone fracture, reduced bone density, and osteoporosis. In a rhesus macaque model of voluntary ethanol consumption, CAC induces functional, transcriptomic, and epigenomic changes in hematopoietic stem and progenitor cells (HSPCs) and their resultant monocytes/macrophages, skewing them toward a hyper-inflammatory response. In the present study, those studies were extended to investigate alterations in osteoclast development, which, in postnatal life, differentiate from HSPCs and play a critical role in maintaining bone homeostasis. Spectral flow cytometry revealed a skewing of HSPCs toward granulocyte-monocyte progenitors in the CAC group, consistent with an increased …

Chronic Alcohol Consumption Reprograms Osteoclast Lineage Communications To Promote Osteoclastogenesis, Hami Hemati, Brianna M. Doratt, Ilhem Messaoudi

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Chronic alcohol consumption increases the risk of osteoporosis and fracture by disrupting bone remodeling, in part by enhancing osteoclastogenesis. However, the cellular mechanisms underlying this process remain incompletely defined. We analyzed scRNA-seq data from osteoclasts differentiated in vitro from bone marrow mononuclear cells obtained from macaques following 12 months of chronic ethanol or isocaloric control solution consumption. Module scoring, trajectory inference with generalized additive modeling (tradeSeq), and CellChat-based analyses of intercellular communication were applied to uncover ethanol-induced changes in metabolic reprogramming, lineage progression, and signaling network dynamics. Module scoring indicated metabolic reprogramming toward oxidative phosphorylation, with reduced glycolytic, migratory, and …

Alcohol Consumption Exacerbates High-Fat Diet- Mediated Disruptions In Myelopoiesis And Osteoclastogenesis In Mouse Models Of Metabolic Dysfunction-Associated Liver Diseases, Hami Hemati, Madison B. Blanton, Lauren Rutt, Nicholas Keiran, Rebecca Geron, Florence Lima, Rebecca L. Mccullough, Ilhem Messaoudi

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Objective: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-Associated Alcohol-related Liver Disease (MetALD) exhibit systemic immune abnormalities. Given that such immune dysregulation is closely linked to the skeletal complications frequently observed in MASLD and MetALD, we sought to comprehensively characterize the bone marrow hematopoietic compartment and its link to osteoclastogenesis.

Methods: We utilized bone marrow from mouse models of MASLD (high-fat diet, HFD) and MetALD (high-fat diet plus ethanol, HFD+EtOH), followed by flow cytometric analysis to phenotype hematopoietic stem and progenitor cells (HSPCs), as well as in vitro and in vivo assays to evaluate osteoclastogenesis.

Results: We found that …

Balancing Face-To-Face And Digital Communication: The Role Of Relationship Maintenance In Dual-Earning Families, Tamara D. Afifi, America L. Edwards

Information Science Faculty Publications

This study examines how face-to-face (FtF) and computer-mediated communication (CMC) contribute to relationship maintenance and resilience in dual-earning families, a largely overlooked area in family communication research. Guided by the theory of resilience and relational load (TRRL), we test how ongoing FtF and CMC maintenance behaviors predicted well-being across a week among 62 families (i.e., two parents and one adolescent). Using a week-long daily diary and physiological measures (cortisol and IL-6 assays), we assess perceived stress, mental health, and loneliness. Findings suggest that both FtF and CMC maintenance are associated with lower stress and better well-being, with FtF showing somewhat …

Buprenorphine Utilization Following Removal Of Prior Authorization Requirements In The Kentucky Medicaid Population, Dustin K. Miracle, Lindsey R. Hammerslag, Svetla Slavova, Michelle R. Lofwall, Sharon L. Walsh, Jeffery Talbert, Patricia R. Freeman

Pharmacy Practice and Science Faculty Publications

Purpose: To evaluate changes in buprenorphine dispensing for treatment of opioid use disorder (OUD) among Kentucky Medicaid enrollees following the removal of prior authorization (PA) requirements for the transmucosal buprenorphine combination product.

Methods: We analyzed Kentucky Medicaid claims from 1/1/2016 through 6/30/2023 to identify enrollees with OUD during each quarter (Q1/2017–Q2/2023), using a 12-month lookback window. Segmented regression analysis was used for statistical modeling of an interrupted time series (ITS) design to assess changes in the quarterly proportion of enrollees with OUD receiving buprenorphine for OUD treatment, focusing on the effect of PA removal. The effective date of the PA …