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Antibiotic use in children - A cross-national analysis of 6 countries.

https://arctichealth.org/en/permalink/ahliterature283568
Source
J Pediatr. 2017 Mar;182:239-244.e1
Publication Type
Article
Date
Mar-2017
Author
Ilan Youngster
Jerry Avorn
Valeria Belleudi
Anna Cantarutti
Javier Díez-Domingo
Ursula Kirchmayer
Byung-Joo Park
Salvador Peiró
Gabriel Sanfélix-Gimeno
Helmut Schröder
Katrin Schüssel
Ju-Young Shin
Sun Mi Shin
Gunnar Skov Simonsen
Hege Salvesen Blix
Angela Tong
Gianluca Trifirò
Tomer Ziv-Baran
Seoyoung C Kim
Source
J Pediatr. 2017 Mar;182:239-244.e1
Date
Mar-2017
Language
English
Publication Type
Article
Keywords
Adolescent
Age Factors
Anti-Bacterial Agents - therapeutic use
Bacterial Infections - drug therapy
Child
Child, Preschool
Cohort Studies
Cross-Sectional Studies
Drug Utilization - statistics & numerical data
Female
Germany
Humans
Incidence
Infant
Internationality
Italy
Male
Norway
Republic of Korea
Retrospective Studies
Spain
United States
Abstract
To describe the rates of pediatric antibiotic use across 6 countries on 3 continents.
Cross-national analysis of 7 pediatric cohorts in 6 countries (Germany, Italy, South Korea, Norway, Spain, and the US) was performed for 2008-2012. Antibiotic dispensings were identified and grouped into subclasses. We calculated the rates of antimicrobial prescriptions per person-year specific to each age group, comparing the rates across different countries.
A total of 74?744?302 person-years from all participating centers were included in this analysis. Infants in South Korea had the highest rate of antimicrobial consumption, with 3.41 prescribed courses per child-year during the first 2 years of life. This compares with 1.6 in Lazio, Italy; 1.4 in Pedianet, Italy; 1.5 in Spain; 1.1 in the US; 1.0 in Germany; and 0.5 courses per child-year in Norway. Of antimicrobial prescriptions written in Norway, 64.8% were for first-line penicillins, compared with 38.2% in Germany, 31.8% in the US, 27.7% in Spain, 25.1% in the Italian Pedianet population, 9.8% in South Korea, and 8% in the Italian Lazio population.
We found substantial differences of up to 7.5-fold in pediatric antimicrobial use across several industrialized countries from Europe, Asia, and North America. These data reinforce the need to develop strategies to decrease the unnecessary use of antimicrobial agents.
PubMed ID
28012694 View in PubMed
Less detail

Consistency of performance ranking of comorbidity adjustment scores in Canadian and U.S. utilization data.

https://arctichealth.org/en/permalink/ahliterature180390
Source
J Gen Intern Med. 2004 May;19(5 Pt 1):444-50
Publication Type
Article
Date
May-2004
Author
Sebastian Schneeweiss
Philip S Wang
Jerry Avorn
Malcolm Maclure
Raia Levin
Robert J Glynn
Author Affiliation
Division of Pharmacoepidemiology and Pharmacoeconomics, Gigham and Women's Hospital and Harvard Medical School, Boston, MA 02120, USA. schneeweiss@post.harvard.edu
Source
J Gen Intern Med. 2004 May;19(5 Pt 1):444-50
Date
May-2004
Language
English
Publication Type
Article
Keywords
Aged
British Columbia - epidemiology
Canada - epidemiology
Comorbidity
Confounding Factors (Epidemiology)
Data Interpretation, Statistical
Female
Forecasting - methods
Health Services - utilization
Health Services Research - methods
Humans
Insurance Claim Review
Male
Medicare - utilization
Mortality
New Jersey - epidemiology
Pennsylvania - epidemiology
Public Health Informatics
Risk Adjustment
United States - epidemiology
Abstract
The performance of standard comorbidity scores to control confounding is poorly defined in health care utilization data across elderly populations. We sought to evaluate and rank the performance of comorbidity scores across selected U.S. and Canadian elderly populations using health care utilization databases.
Cross-population validation study.
Study participants were residents age 65 years or older who had prescription drug coverage through state-funded programs selected from several large health care utilization databases available to the investigators: British Columbia, BC (N = 141,161), New Jersey, NJ (N = 235,881), and Pennsylvania, PA (N = 230,913).
We calculated 6 commonly used comorbidity scores for all subjects during the baseline year (1994 for NJ and PA, and 1995 for BC). These included scores based on diagnoses (Romano, Deyo, D'Hoore, Ghali) and prescription drugs (CDS-1, CDS-2). The study outcome was 1-year mortality. The performance of scores was measured by c-statistics derived from multivariate logistic regression that included age and gender.
Across these 4 large elderly populations, we found the same rank order of performance in predicting 1-year mortality after including age and gender in each model: Romano (c-statistic 0.754 to 0.771), Deyo (c-statistic 0.753 to 0.768), D'Hoore (c-statistic 0.745 to 0.760), Ghali (c-statistic 0.733 to 0.745), CDS-1 (c-statistic 0.689 to 0.738), CDS-2 (c-statistic 0.677 to 0.718), and age and gender alone (c-statistic 0.664 to 0.681). Performance was improved by an average of 6% by adding the number of different prescription drugs received during the past year.
Performance ranking of 6 frequently used comorbidity scores was consistent across selected elderly populations. We recommend that investigators use these performance data as one important factor when selecting a comorbidity score for epidemiologic analyses of health care utilization data.
Notes
Cites: Med Care. 1999 Nov;37(11):1128-3910549615
Cites: Med Care. 2000 Feb;38(2):231-4510659696
Cites: J Clin Epidemiol. 2000 Jun;53(6):571-810880775
Cites: Int J Epidemiol. 2000 Oct;29(5):891-811034974
Cites: Epidemiology. 2001 Jan;12(1):114-2211138805
Cites: Epidemiology. 2001 Nov;12(6):682-911679797
Cites: Am J Epidemiol. 2001 Nov 1;154(9):854-6411682368
Cites: N Engl J Med. 2002 Mar 14;346(11):822-911893794
Cites: Health Serv Res. 2003 Aug;38(4):1103-2012968819
Cites: J Chronic Dis. 1987;40(5):373-833558716
Cites: J Clin Epidemiol. 1989;42(12):1193-2062585010
Cites: J Clin Epidemiol. 1991;44(9):881-81890430
Cites: Am J Public Health. 1992 Feb;82(2):243-81739155
Cites: JAMA. 1992 Apr 22-29;267(16):2197-2031556797
Cites: J Clin Epidemiol. 1992 Feb;45(2):197-2031573438
Cites: Med Care. 1992 May;30(5 Suppl):MS23-411583935
Cites: J Clin Epidemiol. 1992 Jun;45(6):613-91607900
Cites: Med Care. 1992 Oct;30(10):892-9071405795
Cites: Inquiry. 1993 Summer;30(2):199-2078314608
Cites: J Clin Epidemiol. 1993 Oct;46(10):1075-9; discussion 1081-908410092
Cites: Med Care. 1994 Jan;32(1):81-908277803
Cites: Methods Inf Med. 1993 Nov;32(5):382-78295545
Cites: Med Care. 1995 Apr;33(4 Suppl):AS36-467723460
Cites: J Clin Epidemiol. 1995 Jul;48(7):917-267782800
Cites: Med Care. 1995 Aug;33(8):783-957637401
Cites: JAMA. 1995 Sep 13;274(10):801-67650803
Cites: Health Care Financ Rev. 1995 Summer;16(4):189-9910151888
Cites: J Clin Epidemiol. 1996 Mar;49(3):273-88676173
Cites: J Clin Epidemiol. 1996 Dec;49(12):1429-338991959
Cites: Med Decis Making. 1997 Oct-Dec;17(4):447-549343803
Cites: Med Care. 1998 Jan;36(1):8-279431328
Cites: N Engl J Med. 1998 May 21;338(21):1516-209593791
Cites: Circulation. 1998 May 12;97(18):1837-479603539
Cites: Am J Epidemiol. 1999 Mar 15;149(6):541-910084243
Cites: J Clin Epidemiol. 1999 Aug;52(8):781-9010465323
PubMed ID
15109342 View in PubMed
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A cross-national study of the persistence of antihypertensive medication use in the elderly.

https://arctichealth.org/en/permalink/ahliterature159739
Source
J Hypertens. 2008 Jan;26(1):145-53
Publication Type
Article
Date
Jan-2008
Author
Boris L G van Wijk
William H Shrank
Olaf H Klungel
Sebastian Schneeweiss
M Alan Brookhart
Jerry Avorn
Author Affiliation
Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands. b.l.g vanwijk@pharm.uu.nl
Source
J Hypertens. 2008 Jan;26(1):145-53
Date
Jan-2008
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Antihypertensive Agents - therapeutic use
Blood Pressure - drug effects
Canada - epidemiology
Cohort Studies
Cross-Sectional Studies
Female
Follow-Up Studies
Humans
Hypertension - drug therapy
Longitudinal Studies
Male
Netherlands - epidemiology
Patient Compliance - statistics & numerical data
Pennsylvania
Physician's Practice Patterns - statistics & numerical data
Predictive value of tests
Reproducibility of Results
Retrospective Studies
Treatment Outcome
Abstract
Little is known about cross-national comparisons of the persistence of antihypertensive medication treatment, trends in persistence, and factors associated with persistence. The aim of this study was to describe and compare patterns of use of antihypertensive drugs in a population of elderly patients in the United States (Pennsylvania), Canada (British Columbia) and the Netherlands.
A retrospective cohort study of Medicare enrollees in a state pharmacy assistance programme in Pennsylvania (USA), residents from British Columbia (Canada) and residents from the Netherlands registered in the PHARMO database was conducted. Each population included patients 65 years and older who were initiated on blood pressure-lowering treatment between 1 January 1998 and 31 December 2003 and who had continuous follow-up for at least 365 days. In these populations, the proportion of patients with at least 180 consecutive days without medication available (non-persistence) were identified as were predictors of non-persistence using Cox proportional hazards.
A total of 9664 Medicare enrollees (USA), 25 377 residents from British Columbia and 24 603 residents from the Netherlands were evaluated. During the first year after the initiation of treatment, the percentage of patients with at least 180 days without medication was 23.3% in Pennsylvania, 23.4% in British Columbia and 24.0% in the Netherlands. After 6 years, these percentages increased to 41.1, 36.3 and 38.2%, respectively. Factors associated with non-persistence were different between the three countries.
Despite differences in factors associated with persistence, non-persistence patterns are strikingly similar in all three populations. This suggests that the problem of non-persistence transcends international boundaries.
Notes
Cites: N Engl J Med. 2006 Apr 20;354(16):1685-9716537662
Cites: J Am Geriatr Soc. 2000 Feb;48(2):214-710682953
Cites: N Engl J Med. 2001 Sep 20;345(12):851-6011565517
Cites: N Engl J Med. 2001 Sep 20;345(12):870-811565519
Cites: Lancet. 2001 Sep 29;358(9287):1033-4111589932
Cites: Health Aff (Millwood). 2002 Mar-Apr;21(2):13-3011900153
Cites: CMAJ. 2002 Mar 19;166(6):737-4511944760
Cites: JAMA. 2002 Jul 24-31;288(4):455-6112132975
Cites: Lancet. 2000 Jul 29;356(9227):366-7210972368
Cites: J Hypertens. 2001 Feb;19(2):335-4111212978
Cites: CMAJ. 2000 Jan 11;162(1):12, 14; author reply 14, 1811216189
Cites: Arch Intern Med. 2001 Aug 13-27;161(15):1873-911493129
Cites: Curr Hypertens Rep. 2002 Dec;4(6):424-3312419170
Cites: JAMA. 2002 Dec 18;288(23):2981-9712479763
Cites: JAMA. 2003 May 21;289(19):2534-4412759325
Cites: JAMA. 2003 Dec 3;290(21):2805-1614657064
Cites: Hypertension. 2004 Jan;43(1):10-714638619
Cites: Can J Cardiol. 2004 Mar 15;20(4):417-2115057318
Cites: Lancet. 2004 Jun 19;363(9426):2022-3115207952
Cites: J Hum Hypertens. 2004 Aug;18(8):545-5115269704
Cites: J Hypertens. 2004 Sep;22(9):1831-715311113
Cites: N Engl J Med. 1983 Jun 16;308(24):1457-636406886
Cites: J Chronic Dis. 1987;40(5):373-833558716
Cites: J Clin Epidemiol. 1989;42(10):937-452681546
Cites: JAMA. 1990 Mar 23-30;263(12):1653-71968518
Cites: J Epidemiol Community Health. 1992 Apr;46(2):136-401349911
Cites: Inquiry. 1993 Summer;30(2):199-2078314608
Cites: N Engl J Med. 1995 Apr 27;332(17):1125-317700285
Cites: CMAJ. 1996 Jun 15;154(12):1855-648653645
Cites: J Hypertens. 2006 Jun;24(6):1193-20016685222
Cites: JAMA. 1998 May 13;279(18):1458-629600480
Cites: JAMA. 1999 Jul 28;282(4):313-410432015
Cites: Med Care. 1999 Sep;37(9):846-5710493464
Cites: Lancet. 2005 Jan 15-21;365(9455):217-2315652604
Cites: PLoS Med. 2005 May;2(5):e13315916467
Cites: J Hum Hypertens. 2005 Aug;19(8):607-1315920457
Cites: N Engl J Med. 2005 Aug 4;353(5):487-9716079372
Cites: Lancet. 2005 Sep 10-16;366(9489):895-90616154016
Cites: J Hypertens. 2005 Nov;23(11):2101-716208154
Cites: J Clin Epidemiol. 2006 Jan;59(1):11-716360556
Cites: Arch Intern Med. 2006 Feb 13;166(3):332-716476874
Cites: Cochrane Database Syst Rev. 2006;(2):CD00518216625627
PubMed ID
18090552 View in PubMed
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The impact of cost sharing on antidepressant use among older adults in British Columbia.

https://arctichealth.org/en/permalink/ahliterature157979
Source
Psychiatr Serv. 2008 Apr;59(4):377-83
Publication Type
Article
Date
Apr-2008
Author
Philip S Wang
Amanda R Patrick
Colin R Dormuth
Jerry Avorn
Malcolm Maclure
Claire F Canning
Sebastian Schneeweiss
Author Affiliation
National Institute of Mental Health, Bethesda, MD 20892-9629, USA. wangphi@mail.nih.gov
Source
Psychiatr Serv. 2008 Apr;59(4):377-83
Date
Apr-2008
Language
English
Publication Type
Article
Keywords
Adrenergic Uptake Inhibitors - therapeutic use
Aged
Antidepressive Agents - therapeutic use
British Columbia - epidemiology
Cost Sharing - statistics & numerical data
Depressive Disorder - drug therapy - epidemiology
Drug Therapy - trends - utilization
Female
Health Policy
Humans
Imipramine - therapeutic use
Male
Middle Aged
Prevalence
Abstract
Antidepressant therapies are underused among older adults and could be further curtailed by patient cost-sharing requirements. The authors studied the effects of two sequential cost-sharing policies in a large, stable population of all British Columbia seniors: change from full prescription coverage to 10-25 dollars copayments (copay) in January 2002 and replacement with income-based deductibles and 25% coinsurance in May 2003.
PharmaNet data were used to calculate monthly dispensing of antidepressants (in imipramine-equivalent milligrams) among all British Columbia residents age 65 and older beginning January 1997 through December 2005. Monthly rates of starting and stopping antidepressants were calculated. Population-level patterns over time were plotted, and the effects of implementing cost-sharing policies on antidepressant use, initiation, and stopping were examined in segmented linear regression models.
Implementation of the copay policy was not associated with significant changes in level of antidepressant dispensing or the rate of dispensing growth. Subsequent implementation of the income-based deductible policy also did not lead to a significant change in dispensing level but led to a significant (p=.02) decrease in the rate of growth of antidepressant dispensing. The copay policy was associated with a significant (p=.01) drop in the frequency of antidepressant initiation among persons with depression. Income-based deductibles reduced the rate of increase in antidepressant initiation over time. Implementation of the copay and income-based deductible policies did not have significant effects on stopping rates.
Introducing new forms of medication cost sharing appears to have the potential to reduce some use and initiation of antidepressant therapy by seniors. The clinical consequences of such reduced use need to be clarified.
Notes
Cites: J Consult Clin Psychol. 1996 Aug;64(4):660-88803355
Cites: Am J Psychiatry. 1996 Oct;153(10):1353-68831450
Cites: Am J Psychiatry. 1994 May;151(5):716-218166313
Cites: Br J Psychiatry. 1994 Mar;164(3):396-4028199793
Cites: N Engl J Med. 1994 Sep 8;331(10):650-58052275
Cites: Health Care Financ Rev. 1995 Summer;16(4):189-9910151888
Cites: Health Serv Res. 1997 Apr;32(1):103-229108807
Cites: JAMA. 1997 May 28;277(20):1618-239168292
Cites: JAMA. 1997 Oct 8;278(14):1186-909326481
Cites: Med Care. 1997 Nov;35(11):1119-319366891
Cites: JAMA. 1998 Feb 18;279(7):526-319480363
Cites: Community Ment Health J. 1998 Apr;34(2):133-449620158
Cites: N Z Med J. 1998 Aug 14;111(1071):292-49760953
Cites: Lancet. 1998 Dec 5;352(9143):1830-19851392
Cites: Am J Geriatr Psychiatry. 1999 Summer;7(3):235-4310438695
Cites: J Clin Psychopharmacol. 2005 Apr;25(2):118-2615738742
Cites: Med Care. 2005 Oct;43(10):951-916166864
Cites: Health Aff (Millwood). 2005 Jan-Jun;Suppl Web Exclusives:W5-152-W5-16615840625
Cites: N Engl J Med. 2006 Jun 1;354(22):2349-5916738271
Cites: Am J Psychiatry. 2000 Mar;157(3):360-710698810
Cites: J Am Geriatr Soc. 2000 Aug;48(8):871-810968289
Cites: JAMA. 2001 Jan 24-31;285(4):421-911242426
Cites: N Engl J Med. 2001 Mar 29;344(13):1010-511274630
Cites: Am J Geriatr Psychiatry. 2001 Spring;9(2):169-7611316621
Cites: Med Care. 2001 Aug;39(8):772-8411468497
Cites: CMAJ. 2001 Oct 16;165(8):1011-911699696
Cites: Med Care. 2001 Dec;39(12):1293-30411717571
Cites: N Engl J Med. 2002 Mar 14;346(11):822-911893794
Cites: CMAJ. 2002 Mar 19;166(6):737-4511944760
Cites: CMAJ. 2002 Jun 25;166(13):1655-6212126319
Cites: J Clin Pharm Ther. 2002 Aug;27(4):299-30912174032
Cites: Med Care. 2002 Aug;40(8):640-912187178
Cites: JAMA. 2002 Dec 11;288(22):2836-4512472325
Cites: Clin Pharmacol Ther. 2003 Oct;74(4):388-40014534526
Cites: N Engl J Med. 2003 Dec 4;349(23):2224-3214657430
Cites: J Clin Epidemiol. 2004 Feb;57(2):131-4115125622
Cites: JAMA. 2004 May 19;291(19):2344-5015150206
Cites: Med Care. 2004 Jul;42(7):653-6015213490
Cites: Med Care. 1975 Jun;13(6):457-661095839
Cites: Med Care. 1984 Aug;22(8):724-366433121
Cites: Inquiry. 1985 Winter;22(4):396-4032934334
Cites: Soc Sci Med. 1985;21(10):1063-93936186
Cites: Med Care. 1986 Sep;24(9 Suppl):S1-873093785
Cites: N Engl J Med. 1987 Aug 27;317(9):550-63302713
Cites: Med Care. 1990 Oct;28(10):907-172232921
Cites: N Engl J Med. 1991 Oct 10;325(15):1072-71891009
Cites: JAMA. 1992 Aug 26;268(8):1018-241501308
Cites: Inquiry. 1993 Summer;30(2):199-2078314608
PubMed ID
18378836 View in PubMed
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Impact of drug cost sharing on service use and adverse clinical outcomes in elderly receiving antidepressants.

https://arctichealth.org/en/permalink/ahliterature142664
Source
J Ment Health Policy Econ. 2010 Mar;13(1):37-44
Publication Type
Article
Date
Mar-2010
Author
Philip S Wang
Amanda R Patrick
Colin Dormuth
Malcolm Maclure
Jerry Avorn
Claire F Canning
Sebastian Schneeweiss
Author Affiliation
National Institute of Mental Health, 6001 Executive Blvd., Room 8229, MSC 9669, Bethesda, MD 20892, USA.
Source
J Ment Health Policy Econ. 2010 Mar;13(1):37-44
Date
Mar-2010
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Antidepressive Agents - economics - therapeutic use
British Columbia
Cost Sharing - economics - utilization
Cross-Sectional Studies
Depressive Disorder - drug therapy - economics - epidemiology
Drug Costs - statistics & numerical data
Female
Humans
Male
Mental Health Services - economics - utilization
National Health Programs - economics - utilization
Patient Care Team - economics - utilization
Prescription Fees - statistics & numerical data
Referral and Consultation - economics - utilization
Utilization Review - statistics & numerical data
Abstract
Depression imposes enormous burdens on the elderly. Despite this, rates of initiation of and adherence to recommended pharmacotherapy are frequently low in this population. Although initiatives such as the Medicare Modernization Act (MMA) have improved seniors' access to antidepressants, there are concerns that the patient cost-sharing incorporated in the MMA may have unintended consequences if it reduces essential drug use. Age-related pharmacokinetic and pharmacodynamic changes could make seniors particularly vulnerable to antidepressant regimens used inappropriately to save costs, increasing their risks of morbidity, hospitalizations, and nursing home placements. Two sequential large-scale "natural experiments'' in British Columbia provide a unique opportunity to evaluate the effect of cost sharing on outcomes and mental health service use among seniors. In January 2002 the province introduced a CAD 25 copay (CAD10 for low-income seniors). In May 2003 this copay policy was replaced by a second policy consisting of an income-based deductible, 25% coinsurance once the deductible was met, and full coverage once an out-of-pocket ceiling was met. The transition between the two policies is analogous to what many U.S. seniors experience when they transition from private insurance requiring copays to Medicare Part D requiring deductibles and coinsurance.
To evaluate whether declines in antidepressant initiation after the introduction of two drug cost-sharing policies in British Columbia were associated with increased use of physician services, hospitalizations, and nursing home admissions among all British Columbia residents aged 65+.
Records of physician service use, inpatient hospitalizations, and residential care admissions were obtained from administrative databases. Population-level patterns over time were plotted, and effects of implementing the cost-sharing policies examined in segmented linear regression models.
Neither policy affected the rates of visits to physicians or psychiatrists for depression, hospitalizations with a depression diagnosis, or long-term care admissions.
The cost-sharing policies studied may have contained non-essential antidepressant use without substantially increasing mental health service utilization. However, it is possible that the policies had effects that we were unable to detect, such as increasing rates of visits to social workers or psychologists or forcing patients to reduce other spending. Further, the sequential implementation of the policy changes, makes it difficult to estimate the effect of a direct change from full coverage to a coinsurance/income-based deductible policy.
It may be possible to design policies to contain non-essential antidepressant use without substantially increasing other service utilization or adverse events. However, because undertreatment remains a serious problem among depressed elderly, well-designed prescription drug policies should be coupled with interventions to address under-treatment.
Notes
Cites: N Engl J Med. 1978 Sep 28;299(13):690-4355881
Cites: J Clin Psychopharmacol. 2004 Oct;24(5):544-815349013
Cites: Med Care. 2004 Jul;42(7):653-6015213490
Cites: N Engl J Med. 1991 Oct 10;325(15):1072-71891009
Cites: Am J Psychiatry. 1994 May;151(5):716-218166313
Cites: Br J Psychiatry. 1994 Mar;164(3):396-4028199793
Cites: Ann Intern Med. 1994 Aug 1;121(3):200-68017747
Cites: N Engl J Med. 1994 Sep 8;331(10):650-58052275
Cites: Am J Psychiatry. 1996 Oct;153(10):1353-68831450
Cites: JAMA. 1997 May 28;277(20):1618-239168292
Cites: JAMA. 1997 Oct 8;278(14):1186-909326481
Cites: Med Care. 1997 Nov;35(11):1119-319366891
Cites: N Z Med J. 1998 Aug 14;111(1071):292-49760953
Cites: Lancet. 1998 Dec 5;352(9143):1830-19851392
Cites: J Clin Psychopharmacol. 2005 Apr;25(2):118-2615738742
Cites: Med Care. 2005 Oct;43(10):951-916166864
Cites: N Engl J Med. 2006 Jun 1;354(22):2349-5916738271
Cites: Psychiatr Serv. 2008 Apr;59(4):377-8318378836
Cites: J Affect Disord. 2009 May;115(1-2):160-618694602
Cites: Med Care. 2002 Aug;40(8):640-912187178
Cites: J Clin Pharm Ther. 2002 Aug;27(4):299-30912174032
Cites: CMAJ. 2002 Jun 25;166(13):1655-6212126319
Cites: JAMA. 2002 Dec 11;288(22):2836-4512472325
Cites: Am J Psychiatry. 2000 Mar;157(3):360-710698810
Cites: J Am Geriatr Soc. 2000 Aug;48(8):871-810968289
Cites: Health Policy. 2001 Feb;55(2):97-10911163649
Cites: JAMA. 2001 Jan 24-31;285(4):421-911242426
Cites: Am J Geriatr Psychiatry. 2001 Spring;9(2):169-7611316621
Cites: CMAJ. 2001 Oct 16;165(8):1011-911699696
Cites: CMAJ. 2002 Mar 19;166(6):737-4511944760
Cites: Clin Pharmacol Ther. 2003 Oct;74(4):388-40014534526
Cites: Med Care. 2001 Dec;39(12):1293-30411717571
Cites: N Engl J Med. 2002 Mar 14;346(11):822-911893794
PubMed ID
20571181 View in PubMed
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Physician follow-up and provider continuity are associated with long-term medication adherence: a study of the dynamics of statin use.

https://arctichealth.org/en/permalink/ahliterature163990
Source
Arch Intern Med. 2007 Apr 23;167(8):847-52
Publication Type
Article
Date
Apr-23-2007
Author
M Alan Brookhart
Amanda R Patrick
Sebastian Schneeweiss
Jerry Avorn
Colin Dormuth
William Shrank
Boris L G van Wijk
Suzanne M Cadarette
Claire F Canning
Daniel H Solomon
Author Affiliation
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass, USA. abrookhart@rics.bwh.harvard.edu
Source
Arch Intern Med. 2007 Apr 23;167(8):847-52
Date
Apr-23-2007
Language
English
Publication Type
Article
Keywords
British Columbia
Cholesterol - blood
Coronary Disease - prevention & control
Cross-Over Studies
Female
Hospitalization
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Male
Middle Aged
Patient Compliance - statistics & numerical data
Physician's Practice Patterns
Recurrence
Treatment Refusal - statistics & numerical data
Abstract
Many patients who initiate statin (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor) therapy discontinue treatment within 1 year. We sought to estimate the rate at which patients reinitiate treatment after long periods of nonadherence and to determine whether reinitiation of treatment is linked to potentially modifiable factors such as physician visits, cholesterol testing, or other encounters with the health care system.
We studied new users of statins in British Columbia, Canada, who initiated treatment between January 1, 1997, and June 30, 2004, and who had an extended period of nonadherence, defined as at least 90 days after the completion of 1 prescription in which no refill for any statin medication was obtained. Survival analysis was used to estimate the rate of reinitiation of statin therapy. Case-crossover analysis was used to evaluate the predictors of reinitiation.
We identified 239 911 new users of statins, of whom 129 167 (53.8%) had a period of nonadherence that lasted for at least 90 days. Of these patients, an estimated 48% restarted treatment within 1 year and 60% restarted treatment within 2 years. Case-crossover analysis revealed events that were associated with a return to adherence, including visits with the physician who initiated the statin regimen (odds ratio [OR], 6.1; 95% confidence interval [CI], 5.9-6.3), a visit with another physician (OR, 2.9; 95% CI, 2.8-3.0), and a cholesterol test (OR, 1.5; 95% CI, 1.4-1.5). Incident myocardial infarction (OR, 12.2; 95% CI, 8.9-16.9) and other cardiovascular disease-related hospitalizations (OR, 3.6; 95% CI, 3.1-4.3) were also strong predictors of reinitiation of treatment.
Physicians should be aware that statin use is dynamic and that many patients have long periods of nonadherence. A follow-up visit with the physician who wrote the initial statin prescription and having a cholesterol test predicted reinitiation of statin therapy. Our results suggest that continuity of care combined with increased follow-up and cholesterol testing could promote long-term adherence by shortening or eliminating long gaps in statin use. This hypothesis should be confirmed in a randomized experiment.
PubMed ID
17452550 View in PubMed
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A therapeutic substitution policy for proton pump inhibitors: clinical and economic consequences.

https://arctichealth.org/en/permalink/ahliterature169953
Source
Clin Pharmacol Ther. 2006 Apr;79(4):379-88
Publication Type
Article
Date
Apr-2006
Author
Sebastian Schneeweiss
Malcolm Maclure
Colin R Dormuth
Robert J Glynn
Claire Canning
Jerry Avorn
Author Affiliation
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02120, USA. schneeweiss@post.harvard.edu
Source
Clin Pharmacol Ther. 2006 Apr;79(4):379-88
Date
Apr-2006
Language
English
Publication Type
Article
Keywords
2-Pyridinylmethylsulfinylbenzimidazoles
Aged
Aged, 80 and over
Anti-Ulcer Agents - economics - supply & distribution
Benzimidazoles - economics - supply & distribution
British Columbia
Cost Savings
Databases, Factual - statistics & numerical data
Drug Utilization Review
Female
Health Services for the Aged - economics - utilization
Hospitalization - statistics & numerical data
Humans
Insurance, Pharmaceutical Services - economics
Lansoprazole
Male
Omeprazole - analogs & derivatives - economics - supply & distribution
Physician's Practice Patterns - utilization
Rabeprazole
Sulfoxides - economics - supply & distribution
Abstract
With the growing need to provide prescription drug benefits to older patients and to contain costs, it will be necessary to direct that coverage so as to make expenditures as efficient as possible. We evaluated the clinical and economic consequences of coverage restriction for 3 leading proton pump inhibitors (PPIs) in a large-scale natural experiment.
The study design was a time-trend analysis in the setting of a provincial drug benefits program in British Columbia, Canada. We studied all British Columbia residents aged 66 or older (N = 501,104) using linked data on all prescription drug dispensings, physician services, and hospitalizations between January 2002 and June 2004. The new policy restricted coverage to rabeprazole and required treatment failure with a histamine H2 blocker. More widely used PPIs (omeprazole, pantoprazole, and lansoprazole) had to be paid for out of pocket, unless the physician requested an exemption. The main outcome measures were utilization of PPIs, drug discontinuation rates, gastrointestinal hemorrhage rates, and drug expenditures.
Utilization of the restricted PPIs declined sharply after the policy change (-14,850 daily doses per month per 10,000 residents, P
PubMed ID
16580906 View in PubMed
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