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Healthcare-associated infections are common and often preventable infections that lead to high morbidity and mortality rates (1). The bacterium Clostridioides difficile (formerly Clostridium difficile) causes inflammation of the colon, which [...]

Background: Cancer survivors receive more long‐term opioid therapy (LTOT) than people without cancer, but the safety of LTOT prescribing is unknown. Methods: Opioid‐naive adults aged ≥66 years who had been diagnosed in 2008‐2015 with breast, lung, head and neck, or colorectal cancer were identified with data from Surveillance, Epidemiology, and End Results cancer registries linked with Medicare claims. Survivors with 1 or more LTOT episodes (≥90 consecutive days) occurring ≥1 year after their cancer diagnosis and before censoring at hospice entry, another cancer diagnosis, 6 months before death, or December 2016 were included. The safety of prescribing during the first 90 days of the first LTOT episode was measured during follow‐up. As a positive safety indicator, the proportion of survivors with concurrent nonopioid pain management was measured. Indicators of less safe prescribing were the proportion of survivors with a high average daily opioid dose (≥90 morphine milligram equivalents) and the proportion of survivors with concurrent benzodiazepine dispensing. Multivariable logistic regression analyses were conducted to identify clinical predictors of each safety outcome. Results: In all, 3628 cancer survivors received LTOT during follow‐up (median duration, 4.9 months; interquartile range, 3.5‐8.0 months). Seventy‐two percent of the survivors received multimodal pain management concurrently with LTOT. Eight percent of the survivors had high‐dose opioid prescriptions; 25% of the survivors received benzodiazepines during LTOT. Multivariable analyses identified variations in safety measures by multiple clinical factors, although none were consistently significant across outcomes. Conclusions: To improve safe LTOT prescribing for survivors, efforts should focus on increasing multimodal pain management and reducing inappropriate benzodiazepine prescribing. Different clinical predictors of each outcome suggest different drivers of safe prescribing. Cancer survivors are more likely than those without cancer to receive long‐term opioid therapy, and this study of older survivors of cancer finds shortcomings in the safety of long‐term opioid therapy prescribing. Specifically, 28% of survivors receive opioids without concurrent multimodal pain management, 8% of survivors have high average daily opioid doses, and 25% of survivors receive concurrent opioids and benzodiazepines. [ABSTRACT FROM AUTHOR]

Data on the national and state levels is often used to inform policy decisions and strategies designed to reduce racial disparities in obesity. Obesity-related health outcomes are realized on the individual level, and policies based on state and national-level data may be inappropriate due to the variations in health outcomes within and between states. To examine county-level variation of obesity within states, we use a small-area analysis technique to fill the void for county-level obesity data by race. Five years of Behavioral Risk Factor Surveillance System data are used to estimate the prevalence of obesity by county, both overall and race-stratified. A modified weighting system is used based on demographics at the county level using 2010 census data. We fit a multilevel reweighted regression model to obtain county-level prevalence estimates by race. We compare the distribution of prevalence estimates of non-Hispanic Blacks to non-Hispanic Whites. For 25 of the 26 states included in our analysis there is a statistically significant difference between within-state county-level average obesity prevalence rates for non-Hispanic Whites and non-Hispanic Blacks. This study provides information needed to target disparities interventions and resources to the local areas with greatest need; it also identifies the necessity of doing so.