G Caleb Alexander
Dados Biográficos
| ID | 1730304 |
|---|---|
| NOME | G Caleb Alexander |
| PRENOMES | G Caleb |
| SOBRENOME | Alexander |
| ASSINATURA | ALEXANDER G C |
| AFILIAÇÕES | Johns Hopkins University |
| ORCID | 0000-0002-5622-2986 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 33 |
| TOTAL DE CITAÇÕES | 13 |
| TOTAL COMO AUTOR | 33 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1928 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2025 |
| ÍNDICE H | 2 |
Screening, brief intervention, and referral to treatment training for Nigerian primary care physicians
Substance use disorder (SUD) poses a significant public health challenge in sub-Saharan Africa, where evidence-based approaches such as Screening, Brief Intervention, and Referral to Treatment (SBIRT) are rarely integrated into primary healthcare. In Nigeria, primary care providers often lack substance use prevention training, limiting their ability to identify and manage individuals with risky substance use patterns. This pilot study is the firs…
Assessing US Food and Drug Administration Guidance Practices in Drug Development
This Viewpoint discusses the US Food and Drug Administration’s history of guidance documents, trends in publishing practices, and suggested reforms for further improvements
Hospital-Level Variation in Covid-19 Treatment Among Hospitalized Adults in the United States
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To characterize variation in dexamethasone and remdesivir use over time among hospitals. BACKGROUND: Little is known about hospital-level variation in COVID-19 drug treatments in a large and diverse network in the United States. METHODS: We selected individuals hospitalized with COVID-19 across 163 hospitals between February 23, 2020 and October 31, 2021 from using the HCA CHARGE, an electronic…
Recreational and Medical Cannabis Legalization and Opioid Prescriptions and Mortality
The results of this study suggest that, after accounting for biases due to possible heterogeneous effects and simultaneous assessment of recreational and medical cannabis legalization, the implementation of recreational or medical cannabis laws was not associated with opioid prescriptions or opioid mortality, with the exception of a possible reduction in synthetic opioid deaths associated with recreational cannabis law implementation
Estimated Use of Prescription Medications Among Individuals Incarcerated in Jails and State Prisons in the US
In this cross-sectional, descriptive study of the distribution of prescription medications for chronic conditions in jails and state prisons, the findings suggest that there may be underuse of pharmacological treatment in correctional facilities relative to the nonincarcerated population. These findings, which require further investigation, may reflect inadequate care in jails and prisons and represent a critical public health issue
Discontinuation of Buprenorphine Treatment for Opioid Use Disorder During the Coronavirus Disease-2019 Pandemic
BACKGROUND: The coronavirus disease-2019 pandemic has been associated with large increases in opioid-related mortality, yet it is unclear whether specific subpopulations were especially likely to discontinue buprenorphine treatment for opioid use disorder as the pandemic ensued. OBJECTIVE: The aim was to assess predictors of buprenorphine discontinuation in the early months of the coronavirus disease-2019 pandemic (April-July 2020) compared with …
The Opioid Industry Documents Archive
Rejection of Aducanumab (Aduhelm) by the Health Care Community
Changes in Short-term, Long-term, and Preventive Care Delivery in US Office-Based and Telemedicine Visits During the Covid-19 Pandemic
This cross-sectional study's findings suggest that while telemedicine rapidly increased early during course of the COVID-19 pandemic, its use declined modestly since then. In contrast to office-based care, telemedicine was more commonly used for established patients and substantially greater delivery of psychiatric or behavioral treatments rather than preventive care
Quality of Buprenorphine Care for Insured Adults With Opioid Use Disorder
AIM: The aim of this study was to characterize quality of buprenorphine care for opioid use disorder (OUD) by quantifying buprenorphine initiation, engagement, and maintenance for individuals in a large, diverse, real-world cohort in the United States. DESIGN: This was a retrospective cohort analysis. SETTING: OUD treatment in the outpatient setting. PARTICIPANTS: A total of 45,210 commercially insured and Medicare Advantage (MA) enrollees 18 yea…
An Epidemic in the Midst of a Pandemic
Ideas and Opinions2 April 2020An Epidemic in the Midst of a Pandemic: Opioid Use Disorder and COVID-19FREEG. Caleb Alexander, MD, MS, Kenneth B. Stoller, MD, Rebecca L. Haffajee, JD, PhD, MPH, and Brendan Saloner, PhDG. Caleb Alexander, MD, MSJohns Hopkins Bloomberg School of Public Health and Johns Hopkins Medicine, Baltimore, Maryland (G.C.A.), Kenneth B. Stoller, MDJohns Hopkins University School of Medicine, Baltimore, Maryland (K.B.S.), Rebe…
Chronic Disease Medication Adherence After Initiation of Buprenorphine for Opioid Use Disorder
BACKGROUND: Although buprenorphine is an evidence-based treatment for opioid use disorder (OUD), it is unknown whether buprenorphine use may affect patients' adherence to treatments for chronic, unrelated conditions. OBJECTIVES: To quantify the effect of buprenorphine treatment on patient adherence to 5 therapeutic classes: (1) antilipids; (2) antipsychotics; (3) antiepileptics; (4) antidiabetics; and (5) antidepressants. RESEARCH DESIGN: This wa…
More States Should Regulate Pain Management Clinics to Promote Public Health
AffiliationsLainie Rutkow and Jon S. Vernick are with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. G. Caleb Alexander is with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, and the Division of General Internal Medicine, Johns Hopkins Medicine, Baltimore
Evaluating the Impact of Prescription Fill Rates on Risk Stratification Model Performance
BACKGROUND: Risk adjustment models are traditionally derived from administrative claims. Prescription fill rates-extracted by comparing electronic health record prescriptions and pharmacy claims fills-represent a novel measure of medication adherence and may improve the performance of risk adjustment models. OBJECTIVE: We evaluated the impact of prescription fill rates on claims-based risk adjustment models in predicting both concurrent and prosp…
Patterns of Buprenorphine-Naloxone Treatment for Opioid Use Disorder in a Multistate Population
BACKGROUND: Buprenorphine-naloxone treatment for opioid use disorder has rapidly expanded, yet little is known about treatment outcomes among patients in the general population. OBJECTIVE: To examine predictors of treatment duration, dosage, and continuity in a diverse community setting. RESEARCH DESIGN: We examined QuintilesIMS Real World Data, an all-payer, pharmacy claims database, to conduct an analysis of individuals age 18 years and above i…
Effect of Direct-to-Consumer Advertising on Statin Use in the United States
IMPORTANCE: The value of direct-to-consumer advertising (DTCA) of prescription drugs is widely debated, as is the effect of DTCA on prescription sales and health care utilization. OBJECTIVE: We examined the association between DTCA intensity for statin medications and prescription sales and cholesterol-related health care utilization. DESIGN, SETTING, AND PARTICIPANTS: We conducted an ecological study for 75 designated market areas from 2005 to 2…
The Prescription Opioid and Heroin Crisis
Public health authorities have described, with growing alarm, an unprecedented increase in morbidity and mortality associated with use of opioid pain relievers (OPRs). Efforts to address the opioid crisis have focused mainly on reducing nonmedical OPR use. Too often overlooked, however, is the need for preventing and treating opioid addiction, which occurs in both medical and nonmedical OPR users. Overprescribing of OPRs has led to a sharp increa…
Construct Validity and Factor Structure of Survey-based Assessment of Cost-related Medication Burden
BACKGROUND: Millions of Americans are burdened by out-of-pocket prescription costs. Although many survey measures have been developed to assess this burden, the construct validity and the factor structure of these instruments have not been rigorously assessed. OBJECTIVES: To characterize the factor structure and the construct validity of items assessing cost-related medication burden. METHODS: We applied exploratory factor and confirmatory factor…
Disposing of Medicines Safely
AffiliationsKevin M. Fain and G. Caleb Alexander are with the Department of Epidemiology and the Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Mind the Gap
Department of Epidemiology †Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health ‡Division of General Internal Medicine, Johns Hopkins Medicine, Baltimore, MD G.C.A. is supported by the Agency for Healthcare Research and Quality (RO1 HS0189960) and the National Heart, Lung and Blood Institute (R01 HL107345). K.M.F. is supported as a Sommer Scholar at the Johns Hopkins Bloomberg School of Public Health. The fun…
Ambulatory Diagnosis and Treatment of Nonmalignant Pain in the United States, 2000–2010
BACKGROUND: Escalating rates of prescription opioid use and abuse have occurred in the context of efforts to improve the treatment of nonmalignant pain. OBJECTIVE: The aim of the study was to characterize the diagnosis and management of nonmalignant pain in ambulatory, office-based settings in the United States between 2000 and 2010. DESIGN, SETTING, AND PARTICIPANTS: Serial cross-sectional and multivariate regression analyses of the National Amb…
Association Between the Commercial Characteristics of Psychotropic Drugs and Their Off-label Use
BACKGROUND: Off-label prescribing, or the use of a medicine for non-Food and Drug Administration (FDA)-approved indications, is especially common for psychotropic therapies and often lacks scientific support. We quantified the association between 4 commercial characteristics of prescription medicines-product age, therapeutic class age, drug volume, and promotional expenditures-and off-label use of antidepressants, antipsychotics, and mood stabili…
Impact of FDA Drug Risk Communications on Health Care Utilization and Health Behaviors
OBJECTIVE: To review literature on the impact of The Food and Drug Administration (FDA) drug risk communications on medication utilization, health care services use, and health outcomes. DATA SOURCES: The authors searched MEDLINE and the Web of Science for manuscripts published between January 1990 and November 2010 that included terms related to drug utilization, the FDA, and advisories or warnings. We manually searched bibliographies and works …
Clinical Prescribing (and Off-Label Use) in a Second-Best World
From the *Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, IL; †MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, IL; ‡Center for Health and the Social Sciences, University of Chicago, Chicago, IL; and §Department of Pharmacy Administration and Practice, University of Illinois at Chicago, Chicago, IL. Supported by the Agency for Healthcare Research and Quality (K08 HS15699–01A…
The Association Between Family Structure, Reports of Illness and Health Care Demand for Children
Access to health care in lesser-developed countries is often quite limited, especially in rural areas. However, less is known about how different factors, such as household structure, parental income and parental education, modify such access to care. This study uses individual-level data from rural Bangladesh during and following a period of major flooding to examine factors associated with reports of illness and demand for doctors in households…
Lead exposure and child behavior
OBJECTIVES. Unlike cognitive impairments associated with lead exposure, lead-associated child behavior problems have been difficult to specify, particularly in young children. METHODS. The Child Behavior Checklist (CBCL) and the Center for Epidemiologic Studies Depression Scale were used as the outcome and confounding variables, respectively, of major interest. These measures were examined with respect to blood lead levels of 201 African-American…
From the Middle Temple to the South Seas
More States Should Regulate Pain Management Clinics to Promote Public Health
AffiliationsLainie Rutkow and Jon S. Vernick are with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. G. Caleb Alexander is with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, and the Division of General Internal Medicine, Johns Hopkins Medicine, Baltimore
From the Middle Temple to the South Seas
Lead exposure and child behavior
OBJECTIVES. Unlike cognitive impairments associated with lead exposure, lead-associated child behavior problems have been difficult to specify, particularly in young children. METHODS. The Child Behavior Checklist (CBCL) and the Center for Epidemiologic Studies Depression Scale were used as the outcome and confounding variables, respectively, of major interest. These measures were examined with respect to blood lead levels of 201 African-American…
Unnecessary Tests and Ethics of Quality of Care
Case Mr. Mansion, 69, has a history of poorly controlled hypertension, obesity, and a 30-year, pack-a-day smoking habit. During a visit with his primary care physician, Dr. Lal, for a routine annual examination, Mr. Mansion's physical examination is within normal limits with the exception of the conditions noted above
How Good Is Good Enough
Case Dr. Benson is a primary care physician practicing in a town of 5000 people. He often manages patients with complex medical issues and prides himself on his ability to stay current on advances in medical treatment. Each year he exceeds his continuing medical education (CME) requirements, is well respected among his colleagues, and is often consulted by other physicians for difficult cases
Can Healers Have Private Lives
A group of physicians offer commentary about the importance of maintaining an appropriate work-life balance. Virtual Mentor is a monthly bioethics journal published by the American Medical Association
A Crash Course? What Happens When a Patient's Medical and Economic Best Interests Collide
Out-of-pocket costs, particularly for prescription medicines, have captured the attention of the nation. Yet the effects of these common costs are frequently overlooked during patient-physician encounters [1]. Despite the considerable relief that the Medicare Modernization Act will provide for many patients 65 years and older, millions of Americans remain burdened by their prescription costs, and this is unlikely to change any time soon
A conceptually based approach to understanding chronically ill patients’ responses to medication cost pressures
Characteristics of Patients Receiving Pharmaceutical Samples and Association Between Sample Receipt and Out-of-Pocket Prescription Costs
BACKGROUND: Pharmaceutical samples are widely used for promotion and marketing, yet little is known about who receives samples or how their use is associated with patient's prescription costs. OBJECTIVE: To examine the characteristics of those receiving samples and the relationship between sample receipt and out-of-pocket prescription costs. DESIGN, SUBJECTS, AND MEASURES: We divided the 2002-2003 Medical Expenditure Panel Survey, a nationally re…
The Association Between Family Structure, Reports of Illness and Health Care Demand for Children
Access to health care in lesser-developed countries is often quite limited, especially in rural areas. However, less is known about how different factors, such as household structure, parental income and parental education, modify such access to care. This study uses individual-level data from rural Bangladesh during and following a period of major flooding to examine factors associated with reports of illness and demand for doctors in households…
Clinical Prescribing (and Off-Label Use) in a Second-Best World
From the *Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, IL; †MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, IL; ‡Center for Health and the Social Sciences, University of Chicago, Chicago, IL; and §Department of Pharmacy Administration and Practice, University of Illinois at Chicago, Chicago, IL. Supported by the Agency for Healthcare Research and Quality (K08 HS15699–01A…
Association Between the Commercial Characteristics of Psychotropic Drugs and Their Off-label Use
BACKGROUND: Off-label prescribing, or the use of a medicine for non-Food and Drug Administration (FDA)-approved indications, is especially common for psychotropic therapies and often lacks scientific support. We quantified the association between 4 commercial characteristics of prescription medicines-product age, therapeutic class age, drug volume, and promotional expenditures-and off-label use of antidepressants, antipsychotics, and mood stabili…
Impact of FDA Drug Risk Communications on Health Care Utilization and Health Behaviors
OBJECTIVE: To review literature on the impact of The Food and Drug Administration (FDA) drug risk communications on medication utilization, health care services use, and health outcomes. DATA SOURCES: The authors searched MEDLINE and the Web of Science for manuscripts published between January 1990 and November 2010 that included terms related to drug utilization, the FDA, and advisories or warnings. We manually searched bibliographies and works …
Ambulatory Diagnosis and Treatment of Nonmalignant Pain in the United States, 2000–2010
BACKGROUND: Escalating rates of prescription opioid use and abuse have occurred in the context of efforts to improve the treatment of nonmalignant pain. OBJECTIVE: The aim of the study was to characterize the diagnosis and management of nonmalignant pain in ambulatory, office-based settings in the United States between 2000 and 2010. DESIGN, SETTING, AND PARTICIPANTS: Serial cross-sectional and multivariate regression analyses of the National Amb…
Disposing of Medicines Safely
AffiliationsKevin M. Fain and G. Caleb Alexander are with the Department of Epidemiology and the Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Mind the Gap
Department of Epidemiology †Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health ‡Division of General Internal Medicine, Johns Hopkins Medicine, Baltimore, MD G.C.A. is supported by the Agency for Healthcare Research and Quality (RO1 HS0189960) and the National Heart, Lung and Blood Institute (R01 HL107345). K.M.F. is supported as a Sommer Scholar at the Johns Hopkins Bloomberg School of Public Health. The fun…
The Prescription Opioid and Heroin Crisis
Public health authorities have described, with growing alarm, an unprecedented increase in morbidity and mortality associated with use of opioid pain relievers (OPRs). Efforts to address the opioid crisis have focused mainly on reducing nonmedical OPR use. Too often overlooked, however, is the need for preventing and treating opioid addiction, which occurs in both medical and nonmedical OPR users. Overprescribing of OPRs has led to a sharp increa…
Construct Validity and Factor Structure of Survey-based Assessment of Cost-related Medication Burden
BACKGROUND: Millions of Americans are burdened by out-of-pocket prescription costs. Although many survey measures have been developed to assess this burden, the construct validity and the factor structure of these instruments have not been rigorously assessed. OBJECTIVES: To characterize the factor structure and the construct validity of items assessing cost-related medication burden. METHODS: We applied exploratory factor and confirmatory factor…
More States Should Regulate Pain Management Clinics to Promote Public Health
AffiliationsLainie Rutkow and Jon S. Vernick are with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. G. Caleb Alexander is with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, and the Division of General Internal Medicine, Johns Hopkins Medicine, Baltimore
Evaluating the Impact of Prescription Fill Rates on Risk Stratification Model Performance
BACKGROUND: Risk adjustment models are traditionally derived from administrative claims. Prescription fill rates-extracted by comparing electronic health record prescriptions and pharmacy claims fills-represent a novel measure of medication adherence and may improve the performance of risk adjustment models. OBJECTIVE: We evaluated the impact of prescription fill rates on claims-based risk adjustment models in predicting both concurrent and prosp…
Patterns of Buprenorphine-Naloxone Treatment for Opioid Use Disorder in a Multistate Population
BACKGROUND: Buprenorphine-naloxone treatment for opioid use disorder has rapidly expanded, yet little is known about treatment outcomes among patients in the general population. OBJECTIVE: To examine predictors of treatment duration, dosage, and continuity in a diverse community setting. RESEARCH DESIGN: We examined QuintilesIMS Real World Data, an all-payer, pharmacy claims database, to conduct an analysis of individuals age 18 years and above i…
Effect of Direct-to-Consumer Advertising on Statin Use in the United States
IMPORTANCE: The value of direct-to-consumer advertising (DTCA) of prescription drugs is widely debated, as is the effect of DTCA on prescription sales and health care utilization. OBJECTIVE: We examined the association between DTCA intensity for statin medications and prescription sales and cholesterol-related health care utilization. DESIGN, SETTING, AND PARTICIPANTS: We conducted an ecological study for 75 designated market areas from 2005 to 2…
Chronic Disease Medication Adherence After Initiation of Buprenorphine for Opioid Use Disorder
BACKGROUND: Although buprenorphine is an evidence-based treatment for opioid use disorder (OUD), it is unknown whether buprenorphine use may affect patients' adherence to treatments for chronic, unrelated conditions. OBJECTIVES: To quantify the effect of buprenorphine treatment on patient adherence to 5 therapeutic classes: (1) antilipids; (2) antipsychotics; (3) antiepileptics; (4) antidiabetics; and (5) antidepressants. RESEARCH DESIGN: This wa…
An Epidemic in the Midst of a Pandemic
Ideas and Opinions2 April 2020An Epidemic in the Midst of a Pandemic: Opioid Use Disorder and COVID-19FREEG. Caleb Alexander, MD, MS, Kenneth B. Stoller, MD, Rebecca L. Haffajee, JD, PhD, MPH, and Brendan Saloner, PhDG. Caleb Alexander, MD, MSJohns Hopkins Bloomberg School of Public Health and Johns Hopkins Medicine, Baltimore, Maryland (G.C.A.), Kenneth B. Stoller, MDJohns Hopkins University School of Medicine, Baltimore, Maryland (K.B.S.), Rebe…
Changes in Short-term, Long-term, and Preventive Care Delivery in US Office-Based and Telemedicine Visits During the Covid-19 Pandemic
This cross-sectional study's findings suggest that while telemedicine rapidly increased early during course of the COVID-19 pandemic, its use declined modestly since then. In contrast to office-based care, telemedicine was more commonly used for established patients and substantially greater delivery of psychiatric or behavioral treatments rather than preventive care
Quality of Buprenorphine Care for Insured Adults With Opioid Use Disorder
AIM: The aim of this study was to characterize quality of buprenorphine care for opioid use disorder (OUD) by quantifying buprenorphine initiation, engagement, and maintenance for individuals in a large, diverse, real-world cohort in the United States. DESIGN: This was a retrospective cohort analysis. SETTING: OUD treatment in the outpatient setting. PARTICIPANTS: A total of 45,210 commercially insured and Medicare Advantage (MA) enrollees 18 yea…
Medicine (27 obras) · Internal Medicine (13 obras) · Internal Medicine (12 obras) · Medical prescription (12 obras) · Family medicine (11 obras) · Health care (11 obras) · Nursing (10 obras) · Opioid Use Disorder Treatment (10 obras) · Environmental health (9 obras) · Pharmaceutical Economics and Policy (8 obras)