Increased delay from initial concern to diagnosis of autism spectrum disorder and associated health care resource utilization and cost among children aged younger than 6 years in the United States.

Prolonged delays between first caregiver concern and autism spectrum disorder (ASD) diagnosis have been reported, but associations between length of time to diagnosis (TTD) and health care resource utilization (HCRU) and costs have not been studied in a large sample of children with ASD. To address these informational gaps in the ASD diagnostic pathway. This retrospective, observational, single cohort analysis of Optum's administrative claims data from January 1, 2011, to December 31, 2020, included commercially insured children who had 2 or more claims for an ASD diagnosis (earliest diagnosis designated as the index date), were between the ages of older than 1.

Six-Month Use of Droxidopa for Neurogenic Orthostatic Hypotension.

Background: Droxidopa is approved for adult patients with symptomatic neurogenic orthostatic hypotension (nOH); there is limited information regarding effects on symptoms, outcomes, and quality of life (QOL) beyond two weeks of treatment.

Objective: Examine the real-world experience of patients taking droxidopa after six months of treatment.

Methods: This non-interventional, US-based, prospective cohort study utilized a pharmacy hub, identifying patients who recently started droxidopa for nOH treatment.

Relapse prevention: a cost-effectiveness analysis of brexpiprazole treatment in adult patients with schizophrenia in the USA.

Objective: This study used a decision-analytic framework to assess the cost-effectiveness of brexpiprazole vs comparator branded therapies for reducing relapses and hospitalizations among adults with schizophrenia from a US payer perspective.

Methods: An economic model was developed to assess patients with stable schizophrenia initiating treatment with brexpiprazole (1-4 mg), cariprazine (1-6 mg), or lurasidone (40-80 mg) over a 1-year period. After 6 months, patients remained on treatment or discontinued due to relapse, adverse events, or other reasons.

The Current Status of Outcomes-Based Contracting for Manufacturers and Payers: An AMCP Membership Survey.

Background: As the United States health care system shifts from traditional volume-based payments to value-based payments, outcomes-based contracts (OBCs) are gaining popularity among payers and manufacturers as a mechanism for the shift toward value. Under this model, stakeholders hope to align drug payment and value to real-world performance metrics (e.g.

Nursing Home Use Across The Spectrum of Cognitive Decline: Merging Mayo Clinic Study of Aging With CMS MDS Assessments.

Background/objectives: Objective, complete estimates of nursing home (NH) use across the spectrum of cognitive decline are needed to help predict future care needs and inform economic models constructed to assess interventions to reduce care needs.

Design: Retrospective longitudinal study.

Setting: Olmsted County, MN.

Direct medical costs and source of cost differences across the spectrum of cognitive decline: a population-based study.

Background: Objective cost estimates and source of cost differences are needed across the spectrum of cognition, including cognitively normal (CN), mild cognitive impairment (MCI), newly discovered dementia, and prevalent dementia.

Methods: Subjects were a subset of the Mayo Clinic Study of Aging stratified-random sampling of Olmsted County, MN, residents aged 70 to 89 years. A neurologist reviewed provider-linked medical records to identify prevalent dementia (review date = index).

Cost of post-traumatic stress disorder vs major depressive disorder among patients covered by medicaid or private insurance.

Objective: To compare healthcare costs and resource utilization among patients with post-traumatic stress disorder (PTSD) vs control subjects with major depressive disorder (MDD) in populations covered by Medicaid or private insurance.

Study Design: Retrospective analysis of Medicaid and private insurance administrative claims data.

Methods: Patients with at least 2 PTSD diagnoses during or after 1999, and at least 1 PTSD diagnosis during or after 2003, were identified from deidentified Medicaid claims from Florida, Missouri, and New Jersey (1999-2007) and from a privately insured claims database (1999-2008).

Contingency management for smoking cessation: enhancing feasibility through use of immunoassay test strips measuring cotinine.

Contingency management (CM) is a powerful behavioral intervention shown to reduce the use of a variety of substances including tobacco. Use of CM techniques for smoking cessation has been restricted by the use of multiple daily measurements of breath CO as the objective indicator to reinforce abstinence. Cotinine, with its longer half-life, may be a better marker.

Combining cognitive behavioral therapy with contingency management for smoking cessation in adolescent smokers: a preliminary comparison of two different CBT formats.

This pilot study evaluated the optimal format of cognitive behavioral therapy (CBT) to combine with contingency management (CM) in a four-week, high school-based smoking cessation program. Thirty-four adolescent smokers received a standard weekly version of CBT or a frequent brief behavioral intervention. Results indicate a trend toward a higher seven-day point prevalence end-of-treatment abstinence rate and percent days abstinent during treatment in the CBT condition.

Laboratory and self-report assessments of impulsive behavior in adolescent daily smokers and nonsmokers.

This research compared adolescent daily smokers (n=25) and nonsmokers (n=26) on different measures of impulsivity. Assessments included question-based measures of delay (DDQ) and probability (PDQ) discounting, a measure of behavioral disinhibition (go-stop task), and a self-report measure of impulsivity (Barratt Impulsiveness Scale-Adolescent). Adolescent smokers were more impulsive on the DDQ and Barratt Impulsiveness Scale--Adolescent but not on the PDQ or the go-stop task.

Behavioral impulsivity predicts treatment outcome in a smoking cessation program for adolescent smokers.

Objective: To examine the relationship between impulsivity and smoking cessation treatment response among adolescents.

Methods: Thirty adolescent smokers participated in a high school based smoking cessation program combining contingency management and cognitive behavioral therapy. Self-report (Barratt impulsiveness scale (BIS-II); Kirby delay discounting measure (DDM)) and behavioral (experiential discounting task (EDT); continuous performance task (CPT)) measures of impulsivity were assessed at treatment onset.

Contingency management for smoking cessation in adolescent smokers.

This pilot study evaluated the use of contingency management (CM) procedures in combination with cognitive-behavioral therapy (CBT) for smoking cessation in adolescents. Twenty-eight treatment-seeking adolescent smokers participated in a 1-month, school-based smoking cessation program and were randomly assigned to receive either CM with weekly CBT or CBT alone. In the CM+CBT group, biochemical verification of abstinence was obtained twice daily during the first 2 weeks, followed by daily appointments during the 3rd week and once every other day during the 4th week.

Characteristics of adolescent past-year gamblers and non-gamblers in relation to alcohol drinking.

A preliminary examination of mental health and gambling characteristics as a function of alcohol use in adolescents was conducted in a nationally representative sample of 16- and 17-year-olds using data from the 1998 Gambling Impact and Behavior Study. Adolescents were stratified by past-year alcohol use into abstainers/low-frequency (ALF) drinkers and moderate to high-frequency (MHF) drinkers as done previously [Desai, R. A.

Gender and weight concerns in adolescent smokers.

The aim of this study was to examine smoking-specific weight concerns in a well-characterized sample of adolescent daily smokers and the influence of gender, age, and body mass index (BMI). Adolescent smokers (n=103) were asked two smoking-specific weight concern questions: "How much do cigarettes help you control your weight?" and "How concerned are you about gaining weight as a result of quitting?" A significant positive relationship was found between average daily cigarette use and belief in smoking as a means to control weight and a significant negative relationship between the years of smoking and belief that smoking controls weight. There was no significant relationship between BMI and smoking to control weight for females, whereas for males, there was a positive relationship, indicating that heavier males were more likely to report smoking to control weight.

Are fathers involved in pediatric psychology research and treatment?

Background: Recently, there has been a growing awareness of the importance of the roles of fathers in understanding normative developmental processes. Increased attention has been given to the roles of fathers in the area of clinical child research and therapy. However, the presence of fathers in research and treatment in pediatric psychology has not been fully examined.

Daily patterns of alcohol, cigarette, and marijuana use in adolescent smokers and nonsmokers.

Timeline followback (TLFB) methodology was used to assess the daily use of cigarettes, alcohol, and marijuana in adolescent cigarette smokers and nonsmokers over the prior 30 days. Adolescent smokers reported more frequent daily use of both alcohol and marijuana than nonsmokers did. Of those smokers and nonsmokers who drank alcohol and used marijuana, smokers reported more frequent daily use of alcohol, but not marijuana.