Adverse Drug Events by Sex after Adjusting for Baseline Rates of Drug Use

Journal: JAMA Network Open, 2023, doi: 10.1001/jamanetworkopen.2023.29074

Authors: Tamara Rushovich, Annika Gompers, Jeffrey W. Lockhart, Ife Omidiran, Steven Worthington, Sarah S. Richardson, & Katharine M. N. Lee


Although they have known limitations, spontaneous reporting pharmacovigilance databases like the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) and World Health Organization VigiBase are widely cited as evidence for claims that women experience adverse drug events (ADEs) at as high as twice the rate of men. Pharmacokinetics and pharmacodynamics are typically used to explain these sex differences; however, many factors could influence the distribution of ADE reports by sex, including well-known disparities in the rates at which men and women use prescribed drugs. This study examined ADEs reported by sex in the FAERS database after adjusting for drug use by men and women. After accounting for underlying drug use, reported numbers of ADEs were similar between males and females when looking across drugs, suggesting that sex disparities in drug use may largely explain observed sex disparities in ADEs, bolstering evidence from a limited number of prior studies that have accounted for drug use in analyses of sex disparities in ADEs in pharmacovigilance data.

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Preliminary Evidence of the Association between Time on Buprenorphine and Cognitive Performance among Individuals with Opioid Use Disorder Maintained on Buprenorphine: A Pilot Study

Journal: International Journal of Environmental Research and Public Health, 2023, doi: 10.3390/ijerph20166610

Authors: Irene Pericot-Valverde, Kaileigh A. Byrne, Erik G. Ortiz, Stephanie Davis, Ethan Hammond, Shadi Nahvi, James F. Thrasher, … Alain H. Litwin


People on buprenorphine maintenance treatment (BMT) commonly present cognitive deficits that have been associated with illicit drug use and dropout from buprenorphine treatment. This study has compared cognitive responses to the Stroop Task and the Continuous Performance Task (CPT) among individuals on BMT, with recent drug use, and healthy controls and explored the associations between cognitive responses and drug use, craving, and buprenorphine use among participants on BMT. The participants were 16 individuals on BMT and 23 healthy controls. All participants completed a 60 min laboratory session in which they completed the Stroop Task and the CPT, a saliva drug test, a brief clinical history that collected substance-use- and treatment-related information, and the Opioid Craving Scale. The results showed that the BMT participants presented more commission errors (MBMT participants = 2.49; Mhealthy controls = 1.38; p = 0.048) and longer reaction times (MBMT participants = 798.09; Mhealthy controls = 699.09; p = 0.047) in the Stroop Task than did the healthy controls. More days on buprenorphine were negatively associated with reaction time in the CPT (-0.52) and the number of commission errors (-0.53), simple reaction time (-0.54), and reaction time correct (-0.57) in the Stroop Task. Neither drug use nor craving was significantly associated with the results for the cognitive tasks. Relative to the control participants, the BMT individuals performed worse in terms of longer reaction times and more commission errors in the Stroop Task. Within the BMT participants, longer times on buprenorphine were associated with better cognitive results in terms of faster reaction times for both tasks and lower commission errors for the Stroop Task.

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Towards Shortening the Brief Addiction Monitor-Revised (BAM-R)

Journal: Drug and Alcohol Dependence Reports, 2023, doi: 10.1016/j.dadr.2023.100183

Authors: Brittany E. Blanchard, Kevin G. Lynch, Carol A. Malte, Eric J. Hawkins, Dominick DePhilippis, David W. Oslin, James R. McKay, … Andrew J. Saxon


Introduction: The Brief Addiction Monitor-Revised (BAM-R) is a widely used, 17-item assessment of substance use, risk, and protective factors associated with recovery from substance use disorders. Despite wide adoption in the U.S. Department of Veterans Affairs (VA) and recommendations for use in measurement-based care (MBC), administration may not be feasible in many MBC settings due to time constraints. The purpose of this study was to derive a shortened version of the BAM-R for use in fast-paced healthcare settings.

Methods: BAM-R data from 32,002 Veterans were obtained through the VA’s Corporate Data Warehouse. We used logistic regression models to identify items for removal based on prediction of two clinical outcomes (90-day substance use disorder (SUD) treatment retention and 12-month mortality) and item-level sensitivity to change during substance use treatment.

Results: Although no intake BAM-R items predicted SUD treatment retention or mortality, effect sizes for item-level sensitivity to change during substance use treatment varied from small to large. Seven items were judged as relevant for MBC of SUD. Among all BAM-R items, Heavy Alcohol Use, Self-Help, Drug Use, Craving, and Mood items demonstrated the greatest magnitude of sensitivity to change.

Conclusions: Although additional research is recommended before a shortened BAM-R can be implemented in non-specialty MBC settings, we identified 5 BAM-R items with perceived clinical utility and scores that demonstrated evidence of sensitivity to change. Shortening the BAM-R increases feasibility of use, though more work is needed to optimize measurement for SUD MBC.

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Mutual Pathways Between Peer and Own E-Cigarette Use Among Youth in the United States: A Cross-Lagged Model

Journal: BMC Public Health, 2023, doi: 10.1186/s12889-023-16470-5

Authors: Hui G. Cheng, Pavel N. Lizhnyak, & Nadja Richter


Background: Electronic cigarettes (e-cigarettes) have become the most common tobacco product used among adolescents in the United States (US). Prior research has shown that peer e-cigarette use was associated with increased risk of own e-cigarette use. Nonetheless, there is little empirical evidence on the directionality of these associations-if peer use predicts own use (peer influence) or if own use predicts peer use (peer selection).

Methods: We estimated the association between peer and own e-cigarette use among US adolescents 12-17 years of age. We used the cross-lagged model to investigate the mutual relationship between peer and own e-cigarette use over time using data from a population-based longitudinal study, Population Assessment of Tobacco and Health. Stratified analyses were conducted by sex and age subgroups.

Results: Results from a cross-lagged model showed a statistically significant predicting path leading from peer use at the prior time point to own use at the following time point, but not vice versa.

Conclusions: We found strong relationships between peer e-cigarette use and own e-cigarette use at within-individual levels. Peer influence paths were more robust than peer selection paths for e-cigarette use. Incorporating peers into prevention and intervention programs may help enhance these strategies.

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