An economic assessment model for in-center, conventional home, and more frequent home hemodialysis.

More intensive and/or frequent hemodialysis may provide clinical benefits to patients with end-stage renal disease; however, these dialysis treatments are more convenient to the patients if provided in their homes. Here we created a standardized model, based on a systematic review of available costing literature, to determine the economic viability of providing hemodialysis in the home that arrays costs and common approaches for assessing direct medical and nonmedical costs. Our model was based on data from Australia, Canada, and the United Kingdom.

Characterization of ischemic events and use of prescription antiplatelet and anticoagulant agents after stroke or transient ischemic attack.

Stroke patients are at risk for subsequent ischemic events; yet preventive therapy is often underused. An analysis was performed to determine the rate of secondary ischemic events and use of prescription antiplatelets or anticoagulants after ischemic stroke or transient ischemic attack (TIA). Patients age 25 years or older with a medical claim for stroke or TIA between July 1, 1998 and September 30, 1999 were identified from a managed care database.

Patterns of antihypertensive therapy in new users of angiotensin II-receptor blockers.

Purpose: The patterns of angiotensin II-receptor blocker (ARB) therapy in patients with and without a history of antihypertensive use were studied.

Methods: Data for this retrospective cohort study were obtained from Caremark's data warehouse. Patients were included in the analysis if they filled prescriptions for ARBs only, did not receive ARB therapy within the 6 months before the filling of the first ARB prescription (index date), were continuously eligible for benefits for 6 months before the index date, were eligible for prescription benefits for the 12 months following the index date, and were age 20-80 years.

Prescriber intent, off-label usage, and early discontinuation of antidepressants: a retrospective physician survey and data analysis.

Background: Many patients discontinue antidepressant therapy long before the 6-month minimum duration recommended for the treatment of major depression and many other diagnoses. We explore various possibilities, including prescriber intent and patient diagnosis, to explain some of this early discontinuation.

Method: Patients from a single health maintenance organization who filled at least 1 prescription for an antidepressant during the first 4 months of 2001 and who did not fill an antidepressant prescription in the 6 months prior were identified retrospectively.

The impact of treatment-resistant depression on health care utilization and costs.

Background: Approximately 50% of patients diagnosed with major depressive disorder will experience a recurrent or chronic course of illness for which long-term treatment is recommended. Moreover, at least 20% of patients diagnosed with depression do not respond satisfactorily to several traditional antidepressant medication treatment trials. Very little is known about the health care costs of patients with treatment-resistant depression.