Controversy exists regarding the safety of testosterone replacement therapy (TRT) following recent reports an increased risk adverse cardiovascular events.To investigate association between TRT and outcomes in men with androgen deficiency.A retrospective cohort study was conducted within integrated health care delivery system. Men at least 40 years old evidence deficiency either by a coded diagnosis and/or morning serum total level less than 300 ng/dL were included. The eligibility window...

Objective. To evaluate the association between hyperuricemia and renal disease progression in a real-world, large observational database study. Methods. We conducted population-based retrospective cohort study identifying 111,992 patients with (> 7 mg/dl) from medical group. The final were ≥ 18 years old, urate-lowering therapy (ULT)-naïve, had following laboratory results available: at least 1 glomerular filtration rate (GFR) level before index date serum uric acid (sUA) GFR followup...

Abstract Objective To describe the quality of osteoarthritis care provided to community‐dwelling elderly patients and characterize arthritis‐related function in these patients. Methods Two medical groups western United States participated a practice‐redesign intervention targeted at falls mobility disorders, incontinence, cognitive impairment, but not osteoarthritis. From 339 individuals reporting diagnosis arthritis, we collected information on demographics, functional status, via patient...

Primary nonadherence to a medication occurs when drug is prescribed but the patient fails pick prescription up from pharmacy. Managed care organizations that provide integrated using electronic medical records (EMR) are an ideal setting study primary nonadherence. To identify and provider characteristics significantly associated with statin medications compared population of patients who picked their first order. This was retrospective cohort new prescription. Patients order for between...

Background: The interaction between warfarin and nonsteroidal antiinflammatory drugs (NSAIDs) is well known. However, NSAIDs are still commonly prescribed together. Selective cyclooxygenase-2 (COX-2) inhibitors, a newer class of NSAID, offer potential advantages over the nonselective in patients treated with warfarin. Objective: To study rates hospitalization for gastrointestinal (GI) bleeding events 3 groups patients: those taking only, plus selective COX-2 inhibitor. Methods: This was...

Purpose: (1) To assess long-term adherence to American Diabetes Association guideline-recommended retinal screening among population with diabetes in the United States. (2) determine factors associated routine eye exams.Methods: A retrospective cohort study was conducted adult patients identified from January 2009 December 2010. Patients were followed until disenrollment, death, or end date (December 2013). patient defined as adherent when having at least one exam each 12-month period if...

Importance It is unclear whether the effects of intensive vs standard blood pressure (BP) targets seen in clinical trials generalize to patients with chronic kidney disease (CKD) encountered everyday practice due differences distribution cardiovascular risk factors and coexisting conditions. Objective To evaluate beneficial adverse BP control observed Systolic Blood Pressure Intervention Trial (SPRINT) are transportable a target population adults CKD practice. Design, Setting, Participants...

Objectives Concomitant use of cytochrome P-450 and P-glycoprotein (CYP 3A4/P-gp) inducing antiseizure medications direct oral anticoagulants (DOAC) may result in reduced DOAC effectiveness, but study results are inconsistent variable quality. The purpose this was to assess the safety concomitant CYP 3A4/P-gp use. Methods This a retrospective cohort adult patients who were newly, concomitantly receiving (apixaban, dabigatran, or rivaroxaban) either inducer (carbamazepine, phenytoin,...

There may be patient concerns with switching to a biosimilar product. The purpose of this study was describe the perspectives patients inflammatory bowel diseases (IBD) after from reference product (RP) adalimumab adalimumab-atto. This telephonic survey US IBD conducted in June-July 2023 among adult, English-speaking who were switched adalimumab-atto RP within previous 100 days, and receiving at time survey. Consented participants queried on safety effectiveness, cost, preference, education...

To examine the associations between lowering low-density lipoprotein cholesterol (LDL-C) and cardiovascular (CV) outcomes among patients with rheumatoid arthritis (RA) without it.Adult RA 2 age- sex-matched control cohorts [RA plus general controls (RA/GN), osteoarthritis (OA) (RA/OA)] were identified January 1, 2007, December 31, 2011. Patients a diagnosis of hyperlipidemia who initiated statin therapy prior CV events included. Multivariable Cox proportional hazard analyses used.The study...

BACKGROUND: In the elderly, use of medications may increase propensity for adverse drug events due to alterations in pharmacokinetic and pharmacodynamic profiles from normal aging processes. Deprescribing is planned supervised process dose reduction or discontinuation that lead harm are no longer beneficial. While there studies detailing strategies deprescribe such as benzodiazepines antipsychotics nursing homes patients with dementia, a lack guidance safely chronic medications,...

ABSTRACT Purpose The aim of this study was to develop an automated causality assessment algorithm identify drug‐induced liver injury. Methods Roussel Uclaf Causality Assessment Method (RUCAM) is for determining the causal association between a drug and In collaboration with hepatology experts, definitions were developed RUCAM criteria operationalize electronic (eRUCAM). eRUCAM tested in population patients taking 14 drugs characteristic phenotype Quality assurance programming specifications...

The aim was to compare outcomes in adult patients with inflammatory bowel disease (IBD) who switched infliximab-dyyb those remained on reference product (RP) infliximab the United States (US) a retrospective, propensity score-matched, non-inferiority cohort trial. This study conducted within US integrated healthcare system and included confirmed diagnosis of Crohn's or ulcerative colitis. A 1:1 score matching utilized match during period April 2016–March 2018 RP infliximab. margin set at +...

Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat symptoms of chronic inflammatory diseases such as osteoarthritis and rheumatoid arthritis; however, they also associated with various adverse effects, including gastrointestinal (GI) bleeding renal harm. As patients get older, some medications may no longer be beneficial or even cause Deprescribing is defined the planned supervised process dose reduction discontinuation medications. While there studies showing that...

The quality of antithrombotic therapy for patients with nonvalvular atrial fibrillation during routine medical care is often suboptimal. Evidence linking stroke and bleeding risk treatment limited. purpose this study was to evaluate the associations between episodes outcomes.

Warfarin is a common treatment option to manage patients with nonvalvular atrial fibrillation (NVAF) in clinical practice. Understanding current pharmacist-led anticoagulation clinic management patterns and associated outcomes important for quality improvement; however, currently little evidence associating exists.To (a) describe warfarin (b) evaluate associations between NVAF an integrated health care system.A retrospective cohort study was conducted among therapy January 1, 2006, December...

Mineralocorticoid receptor antagonist (MRA) when combined with either angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin blockers (ARBs) may provide additional benefits of cardiovascular and kidney disease risk reduction in patients diabetic (DKD) hypertension. We evaluated the effectiveness combination therapy (MRAs, spironolactone eplerenone, plus ACEI/ARB) compared monotherapy (ACEI/ARB only) DKD hypertension.Retrospective cohort study was performed (age ≥ 18 years)...

Examining drug exposure is essential to pharmacovigilance, especially for bisphosphonate (BP) therapy.To examine differences in 4 measures of oral BP exposure: treatment discontinuation, adherence, persistence, and nonpersistence.Among women aged ≥ 50 years who initiated therapy during 2002-2007 with at least 3 health plan membership follow-up, discontinuation was defined by evidence no further the study observation period. Among those 2 filled prescriptions period, adherence calculated each...

<h3>Importance</h3> Clinical trials have demonstrated the antifracture efficacy of bisphosphonate drugs for first 3 to 5 years therapy. However, continuing as long 10 is uncertain. <h3>Objective</h3> To examine association discontinuing at study entry, 2 years, and additional with risk hip fracture among women who had completed treatment entry. <h3>Design, Setting, Participants</h3> This cohort included were members Kaiser Permanente Northern Southern California, integrated health care...

Baclofen and tizanidine are both muscle relaxants that carry the risk for neuropsychiatric events in older adults but there is a lack of data directly comparing their safety. This study aimed to investigate relative between these two medications causing injury delirium adults.This was retrospective cohort completed an integrated healthcare system United States included patients aged 65 years or who started baclofen treatment musculoskeletal pain from January 2016 through December 2018....