Publications by authors named "Alejandro Amill-Rosario"

Article Synopsis
  • - This study examined the frequency and patterns of using multiple psychotropic medications in youths enrolled in Medicaid from 2015 to 2020.
  • - Researchers analyzed data from 126,972 young patients, finding that most used combinations of medications for ADHD, antipsychotics, and antidepressants, with an increase in the average days on these polypharmacy regimens.
  • - The findings indicate a significant annual rise in psychotropic polypharmacy, suggesting that these treatment regimens are becoming more prevalent among young patients over time.
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Background: Child and adolescent antidepressant use increased post-pandemic, but it is unknown if this disproportionally affected those who develop post-acute sequelae of coronavirus disease 2019 (COVID) or long COVID. This study compared the risk of antidepressant initiation among children and adolescents with long COVID with those who had COVID but did not have evidence of long COVID.

Methods: Our retrospective cohort study of children and adolescents aged 3-17 years at the first evidence of COVID or long COVID from October 1, 2021 through April 4, 2022 was conducted within Komodo's Healthcare Map database.

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Article Synopsis
  • The study analyzed changes in psychotropic medication use among children and adolescents from 2019 to 2022, focusing on pre-pandemic, pandemic-year-1, and pandemic-year-2 periods.
  • Incident psychotropic medication initiation was observed at 27.8% pre-pandemic, dropping to 26.0% in pandemic-year-1, and returning to 27.8% in pandemic-year-2, with a significant rise in antidepressant use during the pandemic years.
  • Notably, younger children (ages 6-11) and females showed higher rates of initiating psychotropic medications in pandemic-year-2 compared to the pre-pandemic period.
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Objective: Assess the risk of incident gout following exposure to recombinant zoster vaccine (RZV).

Methods: This case-only, self-controlled risk interval study included a cohort of US fee-for-service Medicare (Part A, B, and D) beneficiaries aged ≥65 years. The exposure was receipt of at least one dose of the two-dose RZV regimen in 2018 or 2019.

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Background: Individual preferences for treatment options for major depressive disorder can impact therapeutic decision making, adherence, and ultimately outcomes.

Objectives: This systematic review of discrete choice experiments (DCEs) on patient preferences for major depressive disorder treatment assessed the range of DCE applications in major depressive disorder to document patient stakeholder involvement in DCE development and to identify the relative importance of treatment attributes.

Methods: We searched MEDLINE via Ovid (1946-present), EMBASE (Elsevier interface), Cochrane Central Register of Controlled Trials (Wiley interface), and PsycINFO (EBSCO interface) databases on 29 May, 2024.

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Objectives: Prior work identified 6 key value elements (attributes of treatment and desired outcomes) for individuals living with major depressive disorder (MDD) in managing their condition: mode of treatment, time to treatment helpfulness, MDD relief, quality of work, interaction with others, and affordability. The objective of our study was to identify whether previous cost-effectiveness analyses (CEAs) for MDD treatment addressed any of these value elements. A secondary objective was to identify whether any study engaged patients, family members, and caregivers in the model development process.

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Increased mental health problems among children and adolescents during the COVID-19 pandemic may have impacted psychotropic medication use. This study describes trends in monthly psychotropic medications before and early in the COVID-19 pandemic among 2- to 17-year-old children and adolescents with mental health disorders. A cross-sectional study design using the 2019-2020 IQVIA™ prescription and medical commercial claims data to estimate the proportion of children and adolescents with any psychotropic prescription in the month out of all with any mental health-related medical or prescription services in the month and the year-over-year percent change.

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Article Synopsis
  • - The study investigates the use of clinical decision support (CDS) in ambulatory clinics and identifies barriers that affect its implementation, highlighting differences based on whether clinics are affiliated with health systems or not.
  • - Data from 821 clinics across 117 medical groups in Minnesota was analyzed, focusing on the use of 7 CDS tools and 7 types of barriers categorized into resource, user acceptance, and technology issues.
  • - Results revealed that clinics within health systems utilized more CDS tools but faced greater barriers related to resources, user acceptance, and workflow redesign; rural clinics particularly struggled with training resources.
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Article Synopsis
  • The study examines the trends in computerized provider order entry (CPOE) usage among health system-affiliated ambulatory clinics from 2014 to 2016.
  • CPOE usage increased from 58% to 67%, with larger clinics and those in multi-hospital systems showing greater adoption.
  • Less frequent use of CPOE in smaller practices may negatively impact patient outcomes, highlighting disparities in care quality.
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Objective: Adoption of health information technology (HIT) is often assessed in surveys of organizations. The validity of data from such surveys for ambulatory clinics has not been evaluated. We compared level of agreement between 1 ambulatory statewide survey and 2 other data sources: a second survey and interviews with survey respondents.

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Objectives: The adoption and use of health information technology (IT) by health systems in ambulatory care can be an important driver of care quality. We examine recent trends in health IT adoption by health system-affiliated ambulatory clinics in the context of the federal government's Meaningful Use and Promoting Interoperability programs.

Study Design: We analyzed a national sample of 17,861 ambulatory clinics affiliated with 1711 health systems, using longitudinal data (2014-2016) from the HIMSS Analytics annual surveys.

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Background: Asthma is a highly prevalent chronic disease. Prevalence and mortality are particularly high in Puerto Ricans living in the United States as compared with other populations.

Objective: To determine asthma mortality rates in Puerto Rico (1980-2007) and to assess the sociodemographic variables that may be associated with these rates.

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