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Biomedical subjects

Jennifer Hall

Publications and source records attributed to Jennifer Hall.

21 records · Page 2Linked to original sources
PubMed2002

Impact of proton pump inhibitor utilization patterns on gastroesophageal reflux disease-related costs.

OBJECTIVE: To determine proton pump inhibitor (PPI) treatment patterns and their effect on costs related to gastroesophageal reflux disease. METHODS: This study used claims data to identify continuously enrolled subjects diagnosed with gastroesophageal reflux disease (GERD) and newly treated with a PPI between Oct. 1, 1999 and March 31, 2000. Data were analyzed for 6 months following PPI initiation. Results were stratified by first PPI filled during the study period. Compliance (as measured by a medication-possession ratio), dosage escalation (> 25 percent of initial dose), and daily average consumption (DACON) were measured. Regression analysis was performed on GERD-related costs using treatment patterns, type of PPI drug, and compliance as independent variables of interest. RESULTS: Of 75,452 subjects, there were 51,232 (67.9 percent) lansoprazole, 22,829 (30.3 percent) omeprazole, and 1,391 (1.8 percent) rabeprazole subjects. The possession ratio was not significantly different by drug. Only 3.5 percent of rabeprazole subjects escalated versus 5.5 percent of omeprazole subjects and 9.3 percent of lansoprazole subjects (p = .0001). Among subjects with esophageal ulcer or hiatal hernia, rabeprazole users had a significantly lower final DACON (1.03) versus both lansoprazole (1.20) and omeprazole subjects (1.22, p = .0299). Subjects who were compliant with therapy (ratio > 0.80) had 43 percent higher GERD-related pharmacy costs and 33 percent higher GERD-related total costs (both p < .001). GERD-related medical costs were not significantly affected by compliance. Subjects who filled lansoprazole prescriptions had 9.4 percent higher GERD-related pharmacy costs versus rabeprazole subjects (p < .01). Omeprazole subjects had 12.5 percent higher GERD-related total costs versus rabeprazole subjects (p < .01), while lansoprazole subjects had 18 percent higher GERD-related total costs versus rabeprazole subjects (p < .001). CONCLUSIONS: Rabeprazole subjects had lower GERD-related costs, less escalation, and lower DACON (measured as number of tablets consumed per day), compared to lansoprazole and omeprazole subjects. Compliance was not significantly different between the drugs, nor did increased compliance decrease GERD-related costs.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMedDate not supplied

Stimulant treatment patterns and compliance in children and adults with newly treated attention-deficit/hyperactivity disorder.

OBJECTIVE: To identify newly treated cases of attention-deficit/hyperactivity disorder (ADHD), assess the presence of comorbid psychiatric conditions, identify pharmacological treatment patterns, and examine treatment compliance rates among children and adults with newly diagnosed and pharmacologically treated ADHD in a managed care population. METHODS: Children (aged 18 years or younger) and adults having newly treated ADHD were identified from medical and pharmacy claims in an administrative claims database from 6 health plans. Claims data for services or products provided between April 1, 1997, and September 30, 1999, was analyzed for the managed care population (604,538 children and 1,542,304 adults). Data on compliance, persistence, and pharmacological treatment patterns were collected for the 6 months prior to and the 18 months following each patient.s initial ADHD pharmacological treatment. A medication possession ratio (MPR) was calculated by dividing the number of days supplied in a prescription by the number of days until the next prescription was filled. Compliance was defined as an MPR >0.8 and persistence as an MPR >0.3. RESULTS: The prevalence of diagnosed ADHD in this population was 0.7% (11,962 [2%] of children and 2,636 [0.2%] of adults) and incidence of ADHD was 0.04% (735 [0.1%] of children and 162 [0.01%] of adults). The most common comorbid psychiatric condition for incident cases was depression (31.6% of children and 63% of adults). Few children and adults switched their initial ADHD treatment agent, 11% and 12%, respectively. Dose titration occurred in 67% of children and 54% of adults. On average, changes in treatment (switching, titrating) took place after 2 to 3 months of treatment. Although patients, on average, obtained more than 6 refills for a total 200 days supply, the majority of patients (84% of children and 88% of adults) were compliant for less than 2 months over the period they were refilling prescriptions. CONCLUSION: Although the majority of patients had dosage changes, these changes typically occurred after several months of treatment. Results suggest that, even though patients continued their ADHD medication for several months, they did not consistently take medication for more than 2 months. Given these treatment patterns, pharmacologic treatment in newly treated ADHD patients may be suboptimal and may impact outcomes, including the effectiveness and cost of treatment.

Adolescent↗