Background Evidence of adherence and persistence patterns in anticoagulation ( AC ) therapy comparing treatment‐naïve non‐naïve patients is lacking. The objective this study was to evaluate medication a real‐world setting among ‐naïve ‐experienced with atrial fibrillation AF who were treated direct oral anticoagulants DOAC s). Methods newly initiating minimum 6 months continuous health plan enrollment pre postindex date (first prescription) identified from the Truven Health MarketScan...

Unexpected growth in medication use has escalated demand for pharmacists that outpaced supply. Responses to the pharmacist shortage include larger workloads and greater of extenders technology. As profession moved from a product orientation (dispensing medications) patient focus, clinical training requirements have expanded. However, structural process barriers, particularly community retail pharmacies, must be addressed improve medication-use process. These issues merit attention health are...

Patients presenting late in the course of kidney disease who require urgent initiation dialysis have traditionally received temporary vascular catheters followed by hemodialysis. Recent changes Medicare payment policy for USA incentivized use peritoneal (PD). Consequently, more expeditious PD late-presenting patients (urgent-start PD) has new attention. Urgent-start been shown to be safe and effective, offers a mechanism increasing utilization. However, there no assessment dialysis-related...

OBJECTIVES: Asthma is a highly prevalent childhood chronic disease, with particularly high rates among poor and minority youth. Psychosocial factors have been linked to asthma severity but remain poorly understood. This study examined (1) relationships between parent child depression posttraumatic stress disorder (PTSD) symptoms, family functioning, control in sample of urban youth uncontrolled (2) functioning as pathway linking outcomes. METHODS: Data were drawn from the baseline cohort...

The efficacy of proton pump inhibitors (PPIs) or histamine-2 receptor antagonists (H2RAs) prescribed as prophylaxis for NSAID-related upper gastrointestinal (UGI) toxicity is dependent upon patient adherence.To describe adherence to prophylactically PPIs and H2RAs in the clinical setting.We conducted a retrospective observational cohort study using Integrated Primary Care Information Project database. population consisted incident non-specific NSAID users PPI H2RA specifically UGI toxicity....

Objectives. To quantify the impact of Medicare Part D eligibility on medication utilization, emergency department use, hospitalization, and preference-based health utility among civilian noninstitutionalized beneficiaries. Study Design. Difference-in-differences analyses were used to estimate effects outcomes by comparing a 12-month period before after implementation using Medical Expenditure Panel Survey. Models adjusted for sociodemographic characteristics status compared beneficiaries...

The growing Latino population is 1.5 times more likely to develop Alzheimer's Disease (AD) and Related Dementias (ADRD) than non-Latino Whites. Interventions that can reduce the risk of ADRD are needed. Older Latinos face many barriers incorporation physical activity (PA) into their daily lives given a lack social support, caregiving responsibilities, lacking resources maintain PA. Walking dancing two most frequently reported forms PA among older Latinos, indoor programs conducted in...

Abstract OBJECTIVES Chronic use of biologic agents is the mainstay for treating moderate to severe Crohn’s disease (CD), but many patients seek stop biologics after achieving a sustained period remission. European studies suggest that cycling may be feasible, as selected regain remission with retreatment relapse following withdrawal. This study aimed characterize and identify factors associated de-escalation in U.S. CD stable disease. METHODS We performed retrospective observational using...

Abstract Background Cost utility analysis (CUA) using SF-36/SF-12 data has been facilitated by the development of several preference-based algorithms. The purpose this study was to illustrate how decision-making could be affected choice algorithms for SF-36 and SF-12, provide some guidance on selecting an appropriate algorithm. Methods Two sets were used: (1) a clinical trial adult asthma patients; (2) longitudinal post-stroke patients. Incremental costs assumed $2000 per year over standard...

Recent trials demonstrated the efficacy of prasugrel and ticagrelor compared with clopidogrel in reduction cardiovascular complications patients acute coronary syndrome (ACS). However, it is unclear how use 3 antiplatelet medications has changed commercially insured since advent new agents.To (a) describe adoption who received percutaneous intervention (PCI) for onset ACS (b) explore patient factors associated selection drug to provide insight into utilization patterns these agents.Patients...

Abstract Objective The aim of this study was to compare online, unsupervised and face-to-face (F2F), supervised valuation EQ-5D-5L health states using composite time trade-off (cTTO) tasks. Methods official EuroQol experimental design protocol for the 86 were implemented in interviewer-assisted, F2F unsupervised, online studies. Validity preferences assessed prevalence inconsistent valuations expected patterns TTO values. Respondent task engagement measured number trade-offs per task....

Background The economic burden of treating end-stage renal disease (ESRD) continues to grow. As one response, effective January 1, 2011, Medicare implemented a bundled prospective payment system (PPS, including injectable drugs) for dialysis patients. This study investigated the 5-year budget impact on under new PPS changes in distribution patients undergoing peritoneal (PD), in-center hemodialysis (ICHD), and home (HHD). Methods An Excel-based model was created assess dialysis-associated...

Objective. To compare and contrast EQ-5D-5L (5L) EQ-5D-3L (3L) health state values derived from a common sample. Methods. Data the 2017 US EQ-5D valuation study were analyzed. Value sets estimated with random-effects linear regression based on composite time trade-off (cTTO) valuations for 3L 5L states 2 approaches to model specification: main effects only additional N3/N45 terms. Properties of descriptive system value set characteristics compared by examining distributions predicted index...

Background: The benefits of automated peritoneal dialysis (APD) have been established, but patient adherence to treatment remains a concern. Remote monitoring (RPM) programs are potential solution; however, the cost implications not well established. This study modeled, from payer perspective, expected net costs and clinical consequences novel RPM program in Colombia. Methods: Amarkov model was used project outcomes for APD patients with without RPM. Clinical inputs were directly estimated...

DISCLOSURES: Dr Tice and Mr Sarker received ICER grants during the conduct of study. Moradi, Ms Herce-Hagiwara, Faghim, Agboola, Rind, Pearson reports from Arnold Ventures, Blue Cross Shield MA, California Healthcare Foundation, The Commonwealth Fund, Peterson Center on Healthcare, study; other Aetna, America's Health Insurance Plans, Anthem, AbbVie, Alnylam, AstraZeneca, Biogen, CA, Cambia Services, CVS, Editas, Express Scripts, Genentech/Roche, GlaxoSmithKline, Harvard Pilgrim, Care...

The purposes of this study were to characterize and quantify workload productivity in hospitals according their size, establish comparative statistics useful for pharmacy administrators as a means contrast efficiency that other similar sizes, provide data enable policymakers better assess staffing resource needs.A 50-item Web-based survey designed illicit information about department staffing, workload, was sent electronically 242 members Consorta, Inc., group-purchasing organization....

DISCLOSURES: Funding for this summary was contributed by Arnold Ventures, The Donaghue Foundation, Harvard Pilgrim Health Care, and Kaiser Foundation Plan to the Institute Clinical Economic Review (ICER), an independent organization that evaluates evidence on value of health care interventions. ICER's annual policy summit is supported dues from AbbVie, America's Insurance Plans, Anthem, Alnylam, AstraZeneca, Biogen, Blue Shield CA, Boehringer-Ingelheim, Cambia Services, CVS, Editas, Evolve...

Poor oral health status and limited access to dental care have been recognized as problems for children from Medicaid low-income families. However, little is known about Medicaid-enrolled in rural areas. This study examines differences between urban counties utilization rates of Illinois enrolled either or the Children's Health Insurance Program. How overall dentist supply, participation rate, county level sociodemographic factors relate are examined. were aggregated into four urban/rural...

Summary Conflicting evidence exists on the epidemiology of type 2 diabetes mellitus (T2 DM ) among patients with sickle cell disease ( SCD ). This study measured prevalence, incidence and clinical outcomes associated T2 in a large US population commercially‐insured adults aged ≥20 years between 2009 2014. Among 7070 , mean age (median) was 39 (37) 60·8% were female. The standardized prevalence showed modest increase, from 15·7% to 16·5% P trend = 0·026), comparable African‐American...