Health Services Administration Commons^™

Harnessing Big Heterogeneous Data To Evaluate The Potential Impact Of Hiv Responses Among Key Populations In Sub-Saharan Africa: Protocol For The Boloka Data Repository Initiative, Refilwe Nancy Phaswana Mafuya, Edith Phalane, Amrita Rao, Kalai Willis, Katherine Rucinski, K. Alida Voet, Amal Abdulrahman, Claris Siyamayambo, Betty Sebati, Mohlago Seloka, Musa Jaiteh, Lerato Lucia Olifant, Katharine Journeay, Haley Sisel, Xiaoming Li Ph.D., Bankole Olatosi Ph.D., Neset Hikmet, Prashant Duhoon, Francois Wolmarans, Yegnanew A. Shiferaw, Lifutso Motsieloa, Mashudu Rampilo, Stefan Baral

Faculty Publications

Background: In South Africa, there is no centralized HIV surveillance system where key populations (KPs) data, including gay men and other men who have sex with men, female sex workers, transgender persons, people who use drugs, and incarcerated persons, are stored in South Africa despite being on higher risk of HIV acquisition and transmission than the general population. Data on KPs are being collected on a smaller scale by numerous stakeholders and managed in silos. There exists an opportunity to harness a variety of data, such as empirical, contextual, observational, and programmatic data, for evaluating the potential impact of HIV …

Longitudinal Assessments Of Viral Rebound Among People With Hiv In South Carolina: A Population-Based Cohort Study, Jiayang Xiao, Xueying Yang Ph.D., Yunqing Ma, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Routinely monitoring viral rebound (VR) is important in the life course of people with HIV (PWH). This study examined risk factors for time to the first VR, the number of VRs and their association with VR history in men who have sex with men (MSM). It includes 8176 adult PWH diagnosed from January 2005 to December 2018, followed until July 2021. We used the Cox model for time to the first VR, the Poisson model for a number of VRs, and logistic regression for VR history in MSM. Younger individuals (50–59 years vs 18–29 years, aHR: 0.43, 95% CI: [0.34, …

Increased Prevalence Of Peripheral Vestibular Disorder Among Patients With Fabry Disease, Tzong Hann Yang, Sudha Xirasagar Mbbs., Ph.D, Yen Fu Cheng, Chin Shyan Chen, Herng Ching Lin

Publications

Background: Although peripheral vestibular disorder is a non-fatal complication of Fabry disease, fatalities have been reported in some case reports and case series. To date, no studies have examined the relative risk of peripheral vestibular disorder in patients with Fabry disease compared to the general population without the condition. Due to the high prevalence of Fabry disease in East Asia and the potential shared pathogenic pathways between Fabry disease and vasculopathy, we conducted a study using a nationwide population-based dataset to compare the prevalence of peripheral vestibular disorder between patients with Fabry disease and matched comparison patients. Methods: Data was …

Associations Of Head And Neck Cancers With Herpes Zoster In The Preceding Five Years, Chao Hung Chen, Sudha Xirasagar Mbbs., Ph.D, Shih Han Hung, Herng Ching Lin, Chin Shyan Chen

Publications

This population-based study investigated the risk of having had prior herpes zoster within five years preceding a diagnosis of head and neck cancer. We conducted a case-control study that included 9,191 patients with a diagnosis of head and neck cancer in Taiwan’s Longitudinal Health Insurance Database 2010 and 36,764 matched controls. We assessed the odds of patients with head and neck cancer having had a diagnosis of herpes zoster during the five years preceding head and neck cancer using multiple logistic regression analysis. The prevalence of prior herpes zoster among the total sample was 4.6%, 7.9% and 3.8% among patients …

Prevalence Of Hearing Loss, Tinnitus, Vertigo And Sudden Deafness Among Patients With Polymyositis And Dermatomyositis, Shih Han Hung, Sudha Xirasagar Mbbs., Ph.D, Luong Huu Dang, Nguyen Kieu Viet-Nhi, Yen Fu Cheng, Chin Shyan Chen, Herng Ching Lin

Publications

Little is known about a possible association of autoimmune inner ear disease among patients diagnosed with polymyositis (PM)/dermatomyositis (DM). This study aimed to explore differences in the prevalence of inner ear symptoms among patients with and without PM/DM using a nationwide population-based dataset. Data for this study were retrieved from the Taiwan National Health Insurance Research Database. The study sample included 1622 patients diagnosed with PM/DM and 8109 propensity-score matched comparison patients without PM/DM. We performed multivariate logistic regressions to calculate odds ratios (ORs) and 95% confidence interval (CI) for tinnitus, hearing loss, sudden deafness, and vertigo among patients with …

Sexual Orientation, Gender Identity And Virologic Failure Among People With Hiv: A Cohort Study In All Of Us Research Program, Fanghui Shi, Ruilie Cai, Buwei He, Xiaoming Li Ph.D., Xueying Yang Ph.D., Sharon Weissman, Bankole Olatosi Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Background: Sexual and gender minorities (SGMs) are at higher risk of HIV incidence compared to their heterosexual cisgender counterparts. Despite the high HIV disease burden among SGMs, there was limited data on whether they are at higher risk of virologic failure, which may lead to potential disease progression and increased transmission risk. The All of Us (AoU) Research Program, a national community-engaged program aiming to improve health and facilitate health equity in the United States by partnering with one million participants, provides a promising resource for identifying a diverse and large volunteer TGD cohort. Leveraging various data sources available through …

The Dynamic Risk Factors Of Cardiovascular Disease Among People Living With Hiv: A Real-World Data Study, Ziang Liu, Jiajia Zhang Ph.D., Xueying Yang Ph.D., Haoyuan Gao, Shujie Chen, Sharon Weissman, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Background: This study aims to investigate the incidence and dynamic risk factors for cardiovascular diseases (CVD) among people living with HIV (PLWH).

Methods: In this population-based statewide cohort study, we utilized integrated electronic health records data to identify adult (age ≥ 18) who were diagnosed with HIV between 2006 and 2019 and were CVD event-free at the HIV diagnosis in South Carolina. The associations of HIV-related factors and traditional risk factors with the CVD incidence were investigated during the overall study period, and by different follow-up periods (i.e., 0-5yrs, 6-10yrs 11-15yrs) using multivariable logistic regression models.

Results: Among 9,082 eligible …

Multi-Level Factors Associated With Hiv Late Presentation With Advanced Disease And Delay Time Of Diagnosis In South Carolina, 2005–2019, Fanghui Shi, Jiajia Zhang Ph.D., Shujie Chen, Xueying Yang Ph.D., Zhenlong Li, Sharon Weissman, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

This study explored individual- and county-level risk factors of late presentation with advanced disease (LPAD) among people with HIV (PWH) and their longer delay time from infection to diagnosis in South Carolina (SC), using SC statewide Enhanced HIV/AIDS Reporting System (eHARS). LPAD was defined as having an AIDS diagnosis within three months of initial HIV diagnosis, and delay time from HIV infection to diagnosis was estimated using CD4 depletion model. 3,733 (41.88%) out of 8,913 adult PWH diagnosed from 2005 to 2019 in SC were LPAD, and the median delay time was 13.04 years. Based on the generalized estimating equations …

The Role Of Telehealth And Obstetrics Capacity On Maternal Health Care: A Mixed Methods Approach, Shanikque L. Barksdale

Theses and Dissertations

Background: The United States (US) is experiencing a maternal health crisis, with rising severe maternal morbidity and mortality rates and persistent racial, ethnic, and geographic disparities. While telehealth can address access challenges, there is limited evidence of its impact on access to maternity care and outcomes among rural and minoritized communities. The overall objective of this study was to analyze the disparities in maternal outcomes and user satisfaction by hospital-based telehealth and obstetric care availability.

Methods: A convergent parallel mixed methods approach was used. A multinomial logistic regression was used to analyze whether the changes in the proportions of hospitals …

Functional Multivariable Logistic Regression With An Application To Hiv Viral Suppression Prediction, Siyuan Guo, Jiajia Zhang Ph.D., Yichao Wu, Alexander C. Mclain Ph.D., James W. Hardin, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Motivated by improving the prediction of the human immunodeficiency virus (HIV) suppression status using electronic health records (EHR) data, we propose a functional multivariable logistic regression model, which accounts for the longitudinal binary process and continuous process simultaneously. Specifically, the longitudinal measurements for either binary or continuous variables are modeled by functional principal components analysis, and their corresponding functional principal component scores are used to build a logistic regression model for prediction. The longitudinal binary data are linked to underlying Gaussian processes. The estimation is done using penalized spline for the longitudinal continuous and binary data. Group-lasso is used to …

Meeting Abstracts From The 5th National Big Data Health Science Conference, Bankole Olatosi, Miranda Nixon, Xiaoming Li

Publications

No abstract provided.

Association Between Direct Access Laws And Physical Therapy Use And The Effect Of Change In Physical Therapy Use On Subsequent Healthcare Spending, Utilization, And Opioid Use, Dakshu Jindal

Theses and Dissertations

Background

Physical therapy (PT) has been recommended as the first-line treatment for patients with incident musculoskeletal conditions without severe trauma. Initial or early use of PT may help address some of the nation’s most pressing health policy challenges, including escalating healthcare spending and an ongoing opioid epidemic, by encouraging the use of physical therapy as a substitute for expensive surgeries and the use of opioids. Yet, state scope of practice laws have historically restricted the diagnosis and treatment of medical conditions to physicians. Traditionally, patients seeking care from a physical therapist had to obtain a referral from a physician first. …

Predictors Of Prior Hiv Testing And Acceptance Of A Community-Based Hiv Test Offer Among Male Bar Patrons In Northern Tanzania, Deng B. Madut, Preeti Manavalan, Antipas Mtalo, Timothy Peter, Jan Ostermann, Bernard Njau, Nathan M. Thielman

Faculty Publications

Community-based HIV testing offers an alternative approach to encourage HIV testing among men in sub-Saharan Africa. In this study, we evaluated a community-based HIV testing strategy targeting male bar patrons in northern Tanzania to assess factors predictive of prior HIV testing and factors predictive of accepting a real-time HIV test offer. Participants completed a detailed survey and were offered HIV testing upon survey completion. Poisson regression was used to identify prevalence ratios for the association between potential predictors and prior HIV testing or real-time testing uptake. Of 359 participants analyzed, the median age was 41 (range 19–82) years, 257 (71.6%) …

Sexual Orientation And Gender Identity Measures And Viral Suppression For People Living With Hiv: A Protocol For A Population-Based Cohort Study, Xueying Yang, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Introduction The measure of sexual orientation and gender identity (SOGI) data in electronic health records (EHR) has been critical for addressing health disparities and inequalities, especially for HIV care. Given that gender and sexual minorities (eg, transgender, men who have sex with men and intersex) are key groups in people living with HIV (PLWH), SOGI data can facilitate a more accurate understanding about the HIV outcomes (eg, viral suppression) among this key group and then lead to tailored therapeutic services. The two-step SOGI collection method as an emerging gender measurement can be used to measure SOGI status in medical settings. …

Use Of Machine Learning Approaches To Predict Transition Of Retention In Care Among People Living With Hiv In South Carolina: A Real-World Data Study, Ruilie Cai, Xueying Yang Ph.D., Yunqing Ma, Hao H. Zhang, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Maintaining retention in care (RIC) for people living with HIV (PLWH) helps achieve viral suppression and reduce onward transmission. This study aims to identify the best machine learning model that predicts the RIC transition over time. Extracting from the enhanced HIV/AIDS reporting system, this study included 9765 PLWH from 2005 to 2020 in South Carolina. Transition of RIC was defined as the change of RIC status in each two–year time window. We applied seven classifiers, such as Random Forest, Support Vector Machine, eXtreme Gradient Boosting and Long–short–term memory, for each lagged response to predict the subsequent year's RIC transition. Classification …

Medicaid Managed Care Restrictions On Medications For The Treatment Of Opioid Use Disorder, Maureen T. Stewart, Christina M. Andrews Ph.D., Sage R. Feltus, Dominic Hodgkin, Constance M. Horgan, Cindy Parks Thomas, Thuong Nong

Faculty Publications

Objective: To examine whether Medicaid managed care plan (MCP) utilization management policies for buprenorphine–naloxone and injectable naltrexone are related to key state Medicaid program policy decisions. Data Sources and Study Setting: We abstracted data on state Medicaid regulatory and policy information from publicly available sources and publicly available insurance benefit documentation from all 241 Medicaid MCPs operating in 2021. Study Design: In this cross-sectional study, we used bivariate and multivariate analyses to examine whether Medicaid MCP prior authorization and quantity limits on receipt of buprenorphine and injectable naltrexone were associated with key state Medicaid choices to leverage federal funds to …

Human Mobility And The Infectious Disease Transmission: A Systematic Review, M. Naser Lessani, Zhenlong Li, Fengrui Jing, Shan Qiao Ph.D., Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Recent decades have witnessed several infectious disease outbreaks, including the coronavirus disease (COVID-19) pandemic, which had catastrophic impacts on societies around the globe. At the same time, the twenty-first century has experienced an unprecedented era of technological development and demographic changes: exploding population growth, increased airline flights, and increased rural-to-urban migration, with an estimated 281 million international migrants worldwide in 2020, despite COVID-19 movement restrictions. In this review, we synthesized 195 research articles that examined the association between human movement and infectious disease outbreaks to understand the extent to which human mobility has increased the risk of infectious disease outbreaks. …

Patterns And Predictors Of Racial/Ethnic Disparities In Hiv Care Continuum In The Southern Usa: Protocol For A Population-Based Cohort Study, Xueying Yang Ph.D., Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Zhenlong Li, Sharon Weissman, Xiaoming Li Ph.D.

Faculty Publications

Introduction Health disparities exist at every step of the HIV care continuum (HCC) among racial/ethnic minority population. Such racial/ethnic disparities may have significantly delayed the progress in HCC in the Southern US states that are strongly represented among geographic focus areas in the 2019 federal initiative titled 'Ending the HIV Epidemic: A Plan for America'. However, limited efforts have been made to quantify the long-term spatiotemporal variations of HCC disparities and their contributing factors over time, particularly in the context of COVID-19 pandemic. This project aims to identify the spatiotemporal patterns of racial disparities of each HCC outcome and then …

Disease Severity Of Covid-19 In Different Phases Of The Pandemic: Do Healthcare Workers Have Better Outcomes?, Xueying Yang Ph.D., Fanghui Shi, Jiajia Zhang Ph.D., Haoyuan Gao, Shujie Chen, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D.

Faculty Publications

Background:

This study aimed to characterize and compare the demographics, clinical profile, and COVID-19 outcomes between healthcare workers (HCWs) and non-HCWs COVID-19 patients diagnosed in different phases of the pandemic defined by the vaccine rollout policy and different variants that circulated in South Carolina (SC).

Methods:

Extracted from the statewide electronic health record data, we analyzed the clinical outcome of 34,502 HCWs and 1,071,020 non-HCWs adults diagnosed with SARS-CoV-2 between March 2, 2020 to April 14, 2022. Logistic regression models were used to explore the association between different pandemic phases and COVID-19 severity-related outcomes.

Results:

Substantial reductions in mortality were …

Racial Disparities In Adequacy Of Prenatal Care During The Covid-19 Pandemic In South Carolina, 2018–2021, Emmanuel Fabrice Julceus Md, Mph, Bankole Olatosi Ph.D., Peiyin Hung Ph.D., Jiajia Zhang Ph.D., Xiaoming Li Ph.D., Jihong Liu Sc.D.

Faculty Publications

Background: During the COVID-19 pandemic, hospitals’ decision of not admitting pregnant women’s partner or support person, and pregnant women’s fear of contracting COVID-19 in hospitals may disrupt prenatal care. We aimed to examine whether prenatal care utilization in South Carolina varied before and during the COVID-19 pandemic, and whether the variation was different by race.

Methods: We utilized 2018–2021 statewide birth certificate data using a pre-post design, including all women who delivered a live birth in South Carolina. The Kotelchuck Index - incorporating the timing of prenatal care initiation and the frequency of gestational age-adjusted visits - was employed to …

Correlates Of Immunization Timeliness In Three South Asian Countries: Secondary Analysis Of Demographic And Health Surveys, Tanzir Ahmed Shuvo

Theses and Dissertations

Despite the availability of effective vaccines, 1.5 million children under the age of 5 years die every year because of vaccine preventable diseases. Improvements in vaccine delivery infrastructure have resulted in relatively high coverage of vaccines, but many children are not receiving their vaccines on a timely basis. Timely administration of routine vaccines recommended by the Expanded Programme on Immunization (EPI) ensures maximum efficacy. It is vital to explore rates of vaccination timeliness and the correlates of timely vaccination among children to design targeted interventions for improving both coverage and timeliness. We conducted a secondary data analysis of the Demographic …

Examining Cancer Patients' Perceptions Of The Impact Of Covid-19 On Teleoncology: Findings From 15 Nigerian Outpatient Cancer Clinics, Adedayo Joseph, Abdul R. Shour, Nwamaka N. Lasebikan, Mutiu A. Jimoh, Bolanle C. Adegboyega, Emmanuella Nwachukwu, Opeyemi Awofeso, Azeezat Ajose, Abiola Ibraheem, Omolara Aminat Fatiregun, Musa Ali-Gombe, Usman M. Aliyu, Abdallah Elsaid Kotkat, Olusegun Abayomi Biyi-Olutunde, Evaristus Oseiwe Oboh, Ismail H. Zubairu, Mohammad Rifat Haider, Bankole Olatosi Ph.D., David Puthoff, Adedayo A. Onitilo

Faculty Publications

Purpose

To examine cancer patients' perspectives on the impact of COVID-19 on teleoncology in Nigeria.

Methods

Data from a multicenter survey conducted at 15 outpatient clinics to 1,097 patients with cancer from April and July 2020 were analyzed. The study outcome was telemedicine, defined as patients who reported their routine follow-up visits were converted to virtual visits because of COVID-19 (coded yes/no). Covariates included patient age, ethnicity, marital status, income, cancer treatment, service disruption, and cancer diagnosis/type. Stata/SE.v.17 (StataCorp, College Station, TX) was used to perform chi-square and logistic regression analyses. P values ≤ .05 were considered statistically significant.

Results …

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Developing An Ethical Framework-Guided Instrument For Assessing Bias In Ehr-Based Big Data Studies: A Research Protocol, Shan Qiao Ph.D., George Khushf, Xiaoming Li, Jiajia Zhang Ph.D., Bankole Olatosi Ph.D.

Faculty Publications

Introduction The emergence of Big Data health research has exponentially advanced the fields of medicine and public health but has also faced many ethical challenges. One of most worrying but still under-researched aspects of the ethical issues is the risk of potential biases in data sets (eg, electronic health records (EHR) data) as well as in the data curation and acquisition cycles. This study aims to develop, refine and pilot test an ethical framework-guided instrument for assessing bias in Big Data research using EHR data sets.

Methods and analysis Ethical analysis and instrument development (ie, the EHR bias assessment guideline) …

Changes In Medicaid Fee-For-Service Benefit Design For Substance Use Disorder Treatment During The Opioid Crisis, 2014 To 2021, Angela Shoulders, Christina Andrews, Melissa A. Westlake, Amanda J. Abraham, Colleen M. Grogan

Faculty Publications

Importance: Medicaid is the largest payer of substance use disorder treatment in the US and plays a key role in responding to the opioid epidemic. However, as recently as 2017, many state Medicaid programs still did not cover the full continuum of clinically recommended care. Objective: To determine whether state Medicaid fee-for-service (FFS) programs have expanded coverage and loosened restrictions on access to substance use disorder treatment in recent years. Design, Setting, and Participants: In 2014, 2017, and 2021, a survey on coverage for substance use disorder treatment was conducted among state Medicaid programs and the District of Columbia with …

Examining The Associations Of The Kidney Allocation System With Patient Sensitivity, Wait Time To Transplant, And Donor Distance, Shamika Danielle Jones

Theses and Dissertations

Background

The Kidney Allocation System (KAS) was created in 2014 to address long wait times for a kidney transplant, inappropriately matched kidneys, and high re-transplantation rates. This research examines the associations of the KAS with the percentage of sensitized patients receiving a kidney transplant, wait time to transplant and the distance between donor and recipient hospitals.

Methods

Data from the Scientific Registry of Transplant Recipients (SRTR) was used for this research. The study population included adults over 18 in the United States who received a kidney transplant between December 4, 2009, and December 4, 2018. Patients simultaneously waitlisted for other …

Beyond Vaccination Coverage: A Critical Look At Zero-Dose Children In Sub-Saharan Africa, Chamberline Ekene Ozigbu

Theses and Dissertations

Background: Despite continuous efforts to enhance childhood vaccination coverage, a considerable number of children in sub-Saharan Africa (SSA) remain unvaccinated (zero-dose). Recent estimates indicate that approximately 17 million zero-dose children reside mainly in 10 Low- and Middle-Income Countries (LMICs) in SSA. The Immunization Agenda 2030 (IA2030) aims to reduce the number of zero-dose children by half, necessitating research to identify populations and groups at higher risk of being unvaccinated.

Objectives: This research sought to (1) examine individual and contextual factors associated with zero-dose status in SSA, (2) assess the geographical clustering of zero-dose children aged 12-59 months in SSA and …

Complementary And Integrative Health (Cih) And Opioid Use Among Adults With Chronic Noncancer Pain In The Us, Yi-Wen Shih

Theses and Dissertations

Chronic noncancer pain (CNCP) is defined as persistent pain lasting for more than three months due to conditions other than malignancy. This condition affects one in five American adults annually. The prescribing of opioids to individuals experiencing CNCP has been recognized as a critical contributor to the ongoing opioid crisis. In 2016, the Centers for Disease Control and Prevention (CDC) recommended Complementary and Integrative Health (CIH) as a nonpharmacologic treatment to be used among adults with CNCP. Despite the potential benefits of CIH for pain relief, there may be a discrepancy between individuals with CNCP and their insurance coverage for …

Patient Experiences And Disparities In Telehealth Hiv Care During The Covid-19 Pandemic: Study Results From The Southern United States, Valerie Yelverton

Theses and Dissertations

Background: To maintain HIV care continuity during the COVID-19 pandemic, most HIV care facilities in the United States adopted telehealth. However, not everyone was participating in telehealth equally. This dissertation seeks to understand experiences with and the use of telehealth in HIV care, and decision processes guiding the selection of visit type during the COVID-19 pandemic.

Methods: Qualitative interviews explored people living with HIV’s (PWH) and HIV care provider’s experiences with telehealth HIV care and visit type decision processes. Quantitative analyses of electronic health record (EHR) data characterized patterns of and disparities in telehealth HIV care during the COVID-19 pandemic. …

Incidence Of Chronic Kidney Disease Following Acute Coronavirus Disease 2019 Based On South Carolina Statewide Data, Roy O. Mathew, Jiajia Zhang Ph.D., Xueying Yang, Shujie Chen, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Background: Coronavirus disease 2019 (COVID-19) was associated with severe acute illness including multiple organ failure. Acute kidney injury (AKI) was a common finding, often requiring dialysis support.

Objective: Define the incidence of new clinically identified chronic kidney disease (CKD) among patients with COVID-19 and no pre-existing kidney disease.

Design Participants: The South Carolina (SC) Department of Health and Environmental Control (DHEC) COVID-19 mandatory reporting registry of SC residents testing for COVID-19 between March 2020 and October 2021 was included.

Design Main Measures: The primary outcome was a new incidence of a CKD diagnosis (N18.x) in those without a pre-existing diagnosis …

Association Of Selected State Policies And Requirements For Buprenorphine Treatment With Per Capita Months Of Treatment, Bradley D. Stein, Brendan K. Saloner, Olivia K. Golan, Barbara Andraka-Christou, Christina M. Andrews Ph.D., Andrew W. Dick, Corey S. Davis, Flora Sheng, Adam J. Gordon

Faculty Publications

IMPORTANCE Expanding the use of buprenorphine for treating opioid use disorder is a critical component of the US response to the opioid crisis, but few studies have examined how state policies are associated with buprenorphine dispensing. OBJECTIVE To examine the association of 6 selected state policies with the rate of individuals receiving buprenorphine per 1000 county residents. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used 2006 to 2018 US retail pharmacy claims data for individuals dispensed buprenorphine formulations indicated for treating opioid use disorder. EXPOSURES State implementation of policies requiring additional education for buprenorphine prescribers beyond waiver training, continuing medical …