Pregnant women are a vulnerable population exposed to opioids in the United States.
 
  To examine trends and factors associated with opioid prescribing to women proximal to pregnancy.
 
  The 2011 to 2015 Medical Expenditure Panel Survey (MEPS) was used to identify participants (n=3020) with self-reported pregnancy or pregnancy-relevant events aged between 18 and 44 years old. To investigate factors associated with opioid prescriptions, we categorized participants into two subgroups having one or more opioid prescription or having none during the observational period. We used survey multivariable logistic regression to identify factors associated with opioid prescribing accounting for the complex survey design in MEPS.
 
  From 2011 to 2015, the prevalence of opioid prescribing among study participants was 31%. Opioids were more likely to be prescribed to women who had psychiatric conditions (odds ratio, 1,76, 95%CI 1.27-2.44, p < 0.001). Other significant factors included being non-Hispanic white or black, living in the South, active tobacco users, and those with lower Physical Component Summary Scores.
 
  Receipt of an opioid prescription in the perinatal period is associated with maternal psychiatric disorders in the United States. Study findings add new data to the literature on opioid use among pregnant women and provide evidence for healthcare providers and policy makers to tailor treatment and educational programs to avoid opioid overuse among pregnant women.
 Receipt of an opioid prescription in the perinatal period is associated with maternal psychiatric disorders in the United States. Study findings add new data to the literature on opioid use among pregnant women and provide evidence for healthcare providers and policy makers to tailor treatment and educational programs to avoid opioid overuse among pregnant women.
  Nursing home residents are especially vulnerable to adverse outcomes after a hurricane. Prior research suggests that emergency department (ED) visits increase among community-residing older adults after natural disasters. However, little is known about the impact of hurricanes on the large population of older adults residing in assisted living (AL) settings, particularly the influence of storms on the rates and causes of ED visits. We examined whether rates of ED use for injuries and other medical reasons increased after Hurricane Irma in 2017 among AL residents in Florida.
 
  Retrospective cohort study.
 
  Samples of 30,358 Medicare fee-for-service beneficiaries in 2016 and 28,922 beneficiaries in 2017 who resided in Florida AL communities.
 
  The number of injury-related and other medical visits per 1,000 person-days within 30 and 90days of September 1 in 2016 and 2017. We adjusted for age, race, sex, and chronic conditions using linear regression with AL fixed effects. We compared the top 10 primary diagnoses resulting in an ED visit between 2016 and2017.
 
  Adjusted rates of injury-related visits were 12.5% higher at 30days but did not differ at 90days. Other medical visits were 12% higher at 30days in 2017 than in 2016 and 7.7% higher at 90days. Heart failure was a leading cause of ED visits within 90days of September 1 in 2017, unlike in2016.
 
  Increased attention should be paid to AL communities in disaster preparedness and response efforts given the increased likelihood of ED visits following a hurricane.
 Increased attention should be paid to AL communities in disaster preparedness and response efforts given the increased likelihood of ED visits following a hurricane.
  Determine the incidence rates of frailty among community-dwelling older veterans.
 
  Population-based retrospective cohort study.
 
  Veterans Health Administration Medical Center study included community-dwelling veterans 60years and older with determinations of frailty from 2013 to 2014 and followed until September2019.
 
  A 31-item frailty index was generated at baseline and during each subsequent primary care encounters as a proportion of potential variables from electronic health record data. Period prevalence was calculated by dividing total number of cases of frailty during the baseline period. After adjusting for covariates, the association of frailty with mortality was determined using a multivariate Cox regression model. Using baseline and follow-up data, incidence rates of frailty per 1000 person/years based on event rates and mean duration of follow-up were calculated, including survivor and entire cohorts.
 
  Patients in this cohort were 16,761 veterans, mean age 72.18 (9.32) years, 74.00% Caucasiancidence of frailty in community dwelling older US veterans. Future studies should be done for identification, implementation of adequate interventions aimed at preventing frailty or reducing frailty-related complications in community dwelling older individuals.
  To determine the effect of introducing an electronic medication management system (EMMS) on deprescribing practice in a post-acute hospital setting.
 
  This study used a before-after study design.
 
  This study examined the admission and discharge medications prescribed to patients admitted to an Australian post-acute hospital before and after the introduction of an EMMS.
 
  Data were collected over a 1-month period before and after the introduction of an EMMS and included summary measures of drug burden including Potentially Inappropriate Medications and the Drug Burden Index. We calculated and compared admission and discharge medication prescription as well as change in medication use before and after the introduction of an EMMS.
 
  Medication prescription data were available for 121 people before and 107 people after EMMS introduction. In both phases, when compared with admission, those discharged were prescribed fewer medications (mean reduction pre-EMMS=2.9, P<.001, post-EMMS=2.6, P<.001), fewer Potentially Inappropriate Medications (mean reduction pre-EMMS=0.4, P<.001, post-EMMS=0.6, P<.001) and had lower Drug Burden Index (mean reduction pre-EMMS=0.1, P<.001, post-EMMS=0.2, P<.001). The degree of reduction in each measure was similar before and after EMMS introduction.
 
  The introduction of an EMMS did not affect deprescribing practice in a post-acute hospital setting. Future work is required to explore the potential for clinical decision support within an EMMS to further improve the safety and effectiveness of deprescribing within post-acute care.
 The introduction of an EMMS did not affect deprescribing practice in a post-acute hospital setting.  https://www.selleckchem.com/products/repsox.html  Future work is required to explore the potential for clinical decision support within an EMMS to further improve the safety and effectiveness of deprescribing within post-acute care.