Recently, the Food and Drug Administration (FDA) issued an advisory stating that atypical antipsychotic medications increase mortality among elderly patients. However, did not apply to conventional medications; risk of death with these older agents is known.We conducted a retrospective cohort study involving 22,890 patients 65 years age or who had drug insurance benefits in Pennsylvania began receiving medication between 1994 2003. Analyses rates Cox proportional-hazards models were used...

From April 1977 to 1981, 420 deliveries of infants insulin-dependent diabetic women were performed in our department. Of the delivered, 23 had congenital malformations (5.5%). The malformation rate was 1.4% for nondiabetic women. Strict metabolic control begun after 8 wk gestation 292 who delivered 22 with (7.5%). Intensive treatment before conception 128 planning pregnancy. There only one this group (0.8%), a significant reduction from anomaly late registrants (X2 = 7.84; P less than 0.01)....

Abstract Objective Systemic lupus erythematosus (SLE) and nephritis (LN) disproportionately affect individuals who are members of racial/ethnic minority groups lower socioeconomic status (SES). This study was undertaken to investigate the epidemiology sociodemographics SLE LN in low‐income US Medicaid population. Methods We utilized Analytic eXtract data, with billing claims from 47 states Washington, DC, for 23.9 million ages 18–65 years were enrolled >3 months 2000–2004. Individuals (≥3...

To develop and validate a maternal comorbidity index to predict severe morbidity, defined as the occurrence of acute end-organ injury, or mortality.

Prescription Refill Management and Its Effect on Adherence: Comment "The Implications of Therapeutic Complexity Adherence to Cardiovascular Medications"

To assess the appropriateness of outpatient antibiotic prescribing for privately insured children and non-elderly adults in US using a comprehensive classification scheme diagnosis codes ICD-10-CM (international diseases-clinical modification, 10th revision), which replaced ICD-9-CM on 1 October 2015.

<b>Objective</b> To examine the teratogenic potential of statins. <b>Design</b> Cohort study. <b>Setting</b> United States. <b>Participants</b> A cohort 886 996 completed pregnancies linked to liveborn infants women enrolled in Medicaid from 2000 2007. <b>Methods</b> We examined risk major congenital malformations and organ specific offspring associated with maternal use a statin first trimester. Propensity score based methods were used control for confounders, including demographic...

Abstract Background: There are few data regarding the utilization of opioids during pregnancy. The objective this study was to define prevalence and patterns opioid use in a large cohort pregnant women who were commercial insurance beneficiaries. Methods: Data for derived from deidentified research database across United States had both medical prescription benefits. By using diagnostic codes, authors defined 534,500 with completed pregnancies enrolled plan 6 months before pregnancy through...

Insurers and policymakers encourage the use of generic drugs to reduce costs, but generics remain underused. We conducted a national survey commercially insured adults evaluate their perceptions about drugs. Patients agreed that are less expensive better value than brand-name drugs, just as safe. However, although 56 percent reported Americans should more generics, only 37.6 prefer take generics. discuss communicating with practitioners substitution, policymakers' role in influencing use....

To investigate the nationwide prevalence, incidence, and sociodemographics of systemic lupus erythematosus (SLE) nephritis among children in US Medicaid beneficiary population.Children ages 3 years to <18 with a diagnosis SLE (defined as ≥3 claims an International Classification Diseases, Ninth Revision [ICD-9] code 710.0 for SLE, each >30 days apart) were identified from Analytic eXtract database 2000 2004. This contains all inpatient outpatient 47 states District Columbia. Lupus was ≥2...

Deviation from evidence-based guidelines in hypertension treatment is common, but its economic impact has not been rigorously studied. Suboptimal prescribing patterns contribute to the high cost of medications for elderly patients as well difficulty providing affordable prescription drug benefits older Americans.To calculate potential savings perspective health care payers that would result increased adherence recommendations managing than 65 years.Comparative analysis prescribed vs regimens...

Background With constrained health-care resources, there is a need to understand barriers cost-effective medication use. Objective To study physician perceptions about generic medications. Methods Physicians used 5-point Likert scales report cost-related nonadherence, the efficacy and quality of medications, preferences for use, implications dispensing samples. Descriptive statistics were assess logistic regression models evaluate predictors perceptions. Results: Among invited sample. 839...

Background: Although many patient, physician, and payment predictors of adherence have been described, knowledge their relative strength overall ability to explain is limited. Objectives: To measure the contributions in explaining statins. Research Design: Retrospective cohort study using administrative data. Subjects: A total 14,257 patients insured by Horizon Blue Cross Shield New Jersey who were newly prescribed a statin cholesterol-lowering medication. Measures: Adherence medication was...

Abstract Introduction The Glasgow Coma Scale (GCS) is the most widely used scoring system for comatose patients in intensive care. Limitations of GCS include impossibility to assess verbal score intubated or aphasic patients, and an inconsistent inter-rater reliability. FOUR (Full Outline UnResponsiveness) score, a new coma scale not reliant on response, was recently proposed. aim present study compare reliability among unselected general critical A further neurologists with that care unit...

Abstract Many medications used to control blood pressure have been associated with bone metabolism. In addition, hypertension itself may be reduced mineral density. We examined the relative risk of fracture among subjects initiating single-drug therapy for antihypertension treatment. assembled a large cohort Medicare beneficiaries diagnosis who had not filled prescription an antihypertensive medication in prior 365 days. All subsequently began treatment single drug. These were followed...

BACKGROUND AND OBJECTIVES: β blockers are widely used in the treatment of hypertensive disorders during pregnancy. These medications cross placenta and may cause physiologic changes neonates exposed utero. We sought to define risks neonatal hypoglycemia bradycardia associated with maternal exposure at time delivery a large, nationwide cohort Medicaid beneficiaries. METHODS: 2 292 116 completed pregnancies linked liveborn infants Medicaid-enrolled women from 2003 2007. examined delivery....

To examine the association between first-trimester angiotensin-converting enzyme (ACE) inhibitor exposure and risk of overall major congenital, cardiac, central nervous system malformations.We used a cohort completed pregnancies linked to liveborn neonates derived from Medicaid claims 2000 2010. We examined malformations associated with an ACE inhibitor. Propensity score-based methods were control for potential confounders including maternal demographics, medical conditions, other...

<h3>Importance</h3> The opioid epidemic continues to be a public health crisis in the US. <h3>Objective</h3> To assess patient factors and early time-varying prescription-related associated with opioid-related fatal or nonfatal overdose. <h3>Design, Setting, Participants</h3> This cohort study evaluated opioid-naive adult patients Oregon using data from Comprehensive Opioid Risk Registry, which links all payer claims other sets state of Oregon. observational, population-based sample filled...

To date, there has been little empirical evidence to support the broader use of value-based insurance design, which lowers copayments for services with high value relative their costs. address this lack data, we evaluated impact program a US corporation, Pitney Bowes. The eliminated cholesterol-lowering statins and reduced them clopidogrel, blood clot inhibitor. We found that policy was associated an immediate 2.8 percent increase in adherence controls, maintained subsequent year. For...

Background: Electronic prescribing (e-prescribing) with formulary decision support (FDS) prompts prescribers to prescribe lower-cost medications and may help contain health care costs.In April 2004, 2 large Massachusetts insurers began providing an e-prescribing system FDS community-based practices.Methods: Using 18 months (October 1, 2003, March 31, 2005) of administrative data, we conducted a prepost study concurrent controls.We first compared the change in proportion prescriptions for 3...