Addiction, Author Interviews, Health Care Systems / 25.05.2024

MedicalResearch.com Interview with: Srivastava Kodavatiganti, MBS Department of Medical Education Geisinger Commonwealth School of Medicine Scranton, PA MedicalResearch.com: What is the background for this study? Response: Prescription and illicit opioid misuse and overdoses have continued to escalate in the U.S. with annual overdoses exceeding 110,000[1]. There was a substantial rise from 2013 to 2022 in the number of opioid-related overdoses due to synthetic opioids [2]. Even nonfatal opioid-involved overdoses increased 4% quarterly between January 2018 and March 2022 as observed by encounters by emergency medical services [3]. Although the eastern U.S. has been particularly impacted by fatal overdoses, annual increases have increased as of last year in the western states including in Nevada (+27.9%), Washington (+36.9%), Oregon (+38.6%), and Alaska (+45.9%).  In contrast, other states have seen more modest changes (New Mexico = +1.3%) including decreases (South Dakota = -2.4%, Nebraska = -19.5%) [1]. These findings underscore the importance for understanding patterns in usage of prevention and treatment strategies. Naloxone is an opioid antagonist which can reverse the effects of an opioid overdose. This crucial lifesaving tool is administered as an injection or as a nasal spray. This study characterized the patterns of naloxone prescriptions in Medicaid patients from 2018 – 2021 and Medicare patients for 2019. State level differences were also quantified as the fold difference in prescribing between the highest and lowest states when correcting for the number of enrollees in each state. (more…)
Author Interviews, Infections / 01.04.2024

MedicalResearch.com Interview with: Maria Y. Tian, MBS Department of Medical Education Geisinger Commonwealth School of Medicine Scranton PA MedicalResearch.com: What is the background for this study? Response: The antibiotic crisis continues to worsen in the United States (U.S.), which has seen an increasing number of deaths associated with antibiotic resistance, becoming one of the most pressing threats to public health. Concurrently, the availability of effective antibiotics are decreasing, which increases the rates and severity of infections, particularly in patients with respiratory tract infections. Unfortunately, a persistent and pernicious contributing factor to the crisis is the unnecessary prescription of antibiotics. In a previous study, 25% of antibiotics prescribed in the outpatient setting to Medicaid beneficiaries were not associated with a provider visit [2]. Furthermore, among 298 million prescriptions filled by 53 million Medicaid patients between 2004 and 2013, 45% of the prescriptions for antibiotics were made without any clear rationale [2]. In our study, we aimed to provide an up-to-date analysis of antibiotic prescribing in the U.S. through examining the temporal profile of outpatient antibiotic use reported by Medical Expenditure Panel System (MEPS) and geographical patterns of antibiotic prescribing rates among US Medicaid program beneficiaries. This will help identify potentially unnecessary prescriptions and inform stewardship efforts. (more…)
Addiction, Author Interviews, Cancer Research, Cannabis / 23.03.2024

MedicalResearch.com Interview with: Brian J. Piper, PhD Associate Professor of Neuroscience Geisinger Commonwealth School of Medicine Scranton PA 18411 MedicalResearch.com: What is the background for this study? Response: Many cancer patients use marijuana to treat pain, nausea, or anxiety, often without communicating this with their health care providers. Two observational studies (1, 2) from a single institution in Israel purporting to find a dangerous drug interaction between medical cannabis and immunotherapy have been cited hundreds of times, including by clinical practice guidelines. The cannabinoid CB2 receptor is found on immune tissues so it is biologically possible that marijuana could make immunotherapies like nivolumab less effective. However, there were anonymous reports on PubPeer (3-5) of many irregularities in the data-analysis. If there were unappreciated differences on other important variables at baseline besides subsequent cannabis use, this could change the interpretation of these influential reports (1, 2). This investigation involved attempting to repeat and verify the data-analysis. (more…)
Author Interviews, Mental Health Research, Pharmaceutical Companies / 14.01.2024

MedicalResearch.com Interview with: Lauren Davis Lauren C. Davis, MBS Department of Medical Education Geisinger Commonwealth School of Medicine Scranton, PA 19409   MedicalResearch.com: What is the background for this study? Response: Financial conflicts of interest (COIs) resulting from ties between academia and industry have been under scrutiny for their potential to hinder the integrity of medical research. COIs can lead to implicit bias, compromise the research process, and erode public trust (1-6). The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), standardizes symptom criteria and codifies psychiatric disorders. This manual contributes to the approval of new drugs, extensions of patent exclusivity, and can influence payers and mental health professionals seeking third-party reimbursements. Given the implications of the DSM on public health, it is paramount that it is free of industry influence. Previous research has shown a high prevalence of industry ties among panel and task force members of the DSM-IV-TR and DSM-5, despite the implementation of a disclosure policy for the DSM-5 (7,8). This study (9) determined the extent and type of COIs received by panel and task-force members of the DSM-5-TR (2022) (10). As the DSM-5-TR did not disclose COI, we used the Center for Medicare and Medicaid Services Open Payments (OP) database (11) to quantify them. (more…)
Author Interviews, Gender Differences / 03.01.2024

MedicalResearch.com Interview with: Christian Carbe, PhD Department of Medical Educatio Geisinger Commonwealth School of Medicine Scranton, PA 18509   MedicalResearch.com: What is the background for this study? Response: Transgender patients often experience pronounced healthcare disparities compared to their cisgender counterparts. Disparities in the treatment of transgender patients resulting from deficiencies in cultural competency perpetuate poor health outcomes, such as suicide, substance misuse, depression, harassment, and victimization. Individuals within the transgender community often face systemic barriers within the medical field, including a lack of comprehensive access to health insurance, discrimination from providers, and incompetent provider training in transgender-specific health needs. This report evaluated the changes in knowledge, attitudes, and beliefs of the psychosocial and medical needs of the transgender community among first-year undergraduate medical students that attended the Northeastern Pennsylvania Trans Health Conference. Our broader goal is to develop and refine longitudinal interventions to improve skills and sensitivity of future physicians to provide compassionate and competent gender diverse and transgender healthcare. (more…)
Author Interviews, Cannabis / 30.08.2023

MedicalResearch.com Interview with: Luke Cavanah, BS Geisinger Commonwealth School of Medicine Scranton, PA MedicalResearch.com: What is the background for this study? Response: It is well-known that schedule II stimulants, which are those that are highly addictive and include amphetamine, methylphenidate, and lisdexamfetamine, have had increasing use and misuse in the US. Despite understanding the presence of this phenomenon, the reason for it is poorly understood. The purpose of this study was to see if rising rates of schedule II stimulants are related to the legalization of medical marijuana. We were interested in this because schedule II stimulants are primarily used as the treatment for attention-deficit hyperactivity disorder (ADHD), chronic cannabis use has been demonstrated to cause neurocognitive deficits resembling that of ADHD, and the conditions have been shown to affect similar brain regions. (more…)
Author Interviews, Cannabis / 07.07.2023

MedicalResearch.com Interview with: Edward Liu, BA Second year medical student Department of Medical Education Geisinger Commonwealth School of Medicine Scranton, PA MedicalResearch.com: What is the background for this study? Response: The use pattern of two FDA approved cannabinoids, dronabinol (Marinol) and cannabidiol (Epidiolex) has not been previously studied. Dronabinol has been approved in the United States since 1985 for chemotherapy induced nausea as well as vomiting and HIV-induced anorexia,1,2 whereas cannabidiol has been approved since 2018 to treat childhood epileptic disorders, Lennox-Gastaut and Dravet syndrome.3 This longitudinal study examined Medicaid claims between 2016-2020 for these two prescription cannabinoids to better comprehend the state-level pharmacoepidemiologic trends and distribution of these drugs in US Medicaid amidst the increasing use of non-pharmaceutical formulations of cannabis. (more…)
Author Interviews / 25.04.2023

MedicalResearch.com Interview with: Mariah W Panoussi, BS, MBS Second-year medical student at Saba University School of Medicine, Saba, Dutch Caribbean Department of Medical Education Geisinger Commonwealth School of Medicine Scranton, PA MedicalResearch.com: What is the background for this study? Response: Clinical guidelines currently state that the atypical antipsychotic clozapine effectively treats patients with treatment-resistant schizophrenia (TRS) 1. TRS occurs in up to one-third of patients with schizophrenia.2,3 However, there is evidence that demonstrates a lack of clozapine utilization by providers.2 This underutilization has been attributed to clozapine’s numerous adverse effects, in particular agranulocytosis.4 Other barriers include close monitoring for agranulocytosis, changes in administration and registry programs, as well as concerns regarding physician’s attitude toward and knowledge about clozapine.4,5 These barriers have thus caused a sizable variation in clozapine usage throughout the US. Using Medicaid data from 2015-2019, we conducted a secondary data analysis to examine the varied usage of clozapine in the US Medicaid programs.6 (more…)
Author Interviews / 13.04.2023

Medicalresearch.com Interview with: Edward Liu, BA Second year medical student Department of Medical Education Geisinger Commonwealth School of Medicine Scranton, PA Medicalresearch.com: What is the background for this study? Response: The United States’ opioid epidemic continues to rise because of increasing opioid use and availability, contributing to prescription opioid misuse, mortality, and rising cost.1 The worsening health and economic impact of opioid use disorder in the US warrants further attention on the adverse effects and distribution pattern of commonly prescribed opioids like oxycodone (OxyContin), fentanyl (Duragesic), and morphine (MS-Contin). Using the Automated Reports and Consolidated Ordering System (ARCOS) database,2 a comprehensive data collection system of pharmacies and hospitals distribution of Schedule II and III controlled substances in the US with the FDA Adverse Event Reporting System (FAERS)3 has never been done before. This approach may provide a more complete picture of the risks of prescription opioids which can include drowsiness, nausea, and potentially fatal respiratory depression.  (more…)
Author Interviews, Education, JAMA, Pharmaceutical Companies / 06.07.2022

MedicalResearch.com Interview with: SooYoung VanDeMark, MBS Geisinger Commonwealth School of Medicine Scranton, Pennsylvania MedicalResearch.com:  What is the background for this study?   Response: Health care providers utilize subscription-based, point-of-care databases such as DynaMed and UpToDate to provide clinical care guidance and remain current on the latest evidence-based findings. Both of these websites maintain this content through a cadre of physician contributors who write and edit articles for these sites. These physician contributors are required to self-report any conflicts of interest (COI) as outlined by the respective policies on each website. However, prior COI research into similarly self-regulated areas, such as medical and pharmacology textbooks, and clinical practice guidelines, has found both appreciable potential COI and inconsistencies between self-reported and industry mandated disclosures (1-3). This study (4) explored the accuracy of physician contributors to DynaMed and UpToDate by comparing their self-reported disclosure status with the financial remunerations they received from the healthcare industry (e.g., pharmaceutical companies) as reported to the U.S. Centers for Medicare and Medicaid Services’ Open Payments database. Physician contributors who reported “nothing to disclose” on their respective article topic but had an entry on Open Payments for having received money from industry, were classified as discordant and, thus, as having the potential for a COI. Additionally, total remuneration, gender, and payment category were investigated more in depth for each database. (more…)
ADHD, Author Interviews, Cost of Health Care, Eating Disorders, Pharmacology / 09.01.2022

MedicalResearch.com Interview with: Sneha Vaddadi, BS Department of Medical Education Geisinger Commonwealth School of Medicine Scranton, Pennsylvania MedicalResearch.com: What is the background for this study? Response: The prescription stimulants methylphenidate, amphetamine, and lisdexamfetamine, classified as Schedule II substances, are sympathomimetic drugs with therapeutic use widely used in the US for Attention Deficit Hyperactivity Disorder. Changes in criteria for diagnosis of Attention Deficit Hyperactivity Disorder in 2013 and approval of lisdexamfetamine for binge eating disorder in 2015 may have impacted usage patterns. The goal of this study1 was to extend upon past research2 to compare the pharmacoepidemiology of these stimulants in the United States from 2010–2017, including consideration to variation within geographic regions, the Hispanic population, and the Medicaid population. (more…)