Publications by authors named "Brian J Quilliam"
Introduction And Objective: Receipt of opioid agonist treatment during early and late pregnancy for opioid use disorder may relate to varying perinatal risks. We aimed to assess the effect of time-varying prenatal exposure to opioid agonist treatment using buprenorphine or methadone on adverse neonatal and pregnancy outcomes.
Methods: We conducted a retrospective cohort study of pregnant women with opioid use disorder using Rhode Island Medicaid claims data and vital statistics during 2008-16.
Introduction: Several studies have reported increasing prevalence of prescription opioid use among pregnant women. However, little is known regarding the effects of maternal opioid use on neurodevelopmental disorders in early childhood in pregnant women with no evidence of opioid use disorders or drug dependence.
Objective: The aim of this study was to quantify the association between prenatal opioid exposure from maternal prescription use and neurodevelopmental outcomes in early childhood.
Objective: The aim of this study was to estimate the incidence and identify the factors associated with neonatal readmission among healthy term infants.
Study Design: A nested case-control study with matching was conducted at a large level III perinatal hospital with approximately 8,700 deliveries each year. Each case infant ( = 130) was matched to two control infants ( = 260) on the case infant's date of birth (±7 days) and the mother's maternal age (<20 years, 20-29, 30-39, and >39 years).
Objective: To describe persistence to newly prescribed antidepressant medications within the Rhode Island Medicaid population.
Methods: This retrospective study analyzed antidepressant medication persistence in a cohort of new users for a period spanning 2013-2014, focusing on the acute treatment phase (first 12 weeks of treatment). Covariates assessed included patient gender, age, comorbidity status, and measures of health system utilization.
Background: While the economic costs of pain have been documented, the impact of noncancer pain on quality of life has not been studied extensively.
Objective: To estimate the influence of noncancer pain on quality of life measures.
Design: Prospective, multicenter, observational nonrandomized patient pain registry.
Purpose: Results of a pharmacoepidemiologic evaluation of fluoroquinolone-associated hepatotoxicity using national hospital admissions data on Veterans Affairs (VA) patients are reported.
Methods: In a retrospective case-control study, all adults with a primary diagnosis of hepatotoxicity on admission to a VA facility during a 6.5-year period (January 2002-June 2008) were identified.
Context: Either a two-factor representation (pain intensity and interference) or a three-factor representation (pain intensity, activity interference, and affective interference) of the modified Brief Pain Inventory (BPI) is appropriate among cancer patients.
Objectives: To evaluate the extent to which a three-factor representation (pain intensity, activity interference, and affective interference) is appropriate for BPI among patients with noncancer pain seen in an outpatient setting.
Methods: We conducted a prospective, multicenter, observational, nonrandomized study using patient pain registry data from outpatient settings.
Background: Gastrointestinal (GI) adverse effects are common with oral opioid treatments; their impact on health-related quality of life (HRQoL) is poorly understood.
Objectives: To estimate the extent to which GI adverse effects impact HRQoL.
Design: 28-day prospective, multicenter, observational registry.
Introduction: The availability of comprehensive and accurate medication history information in electronic medical records and through electronic prescribing provides the opportunity to create tailored interventions based on individuals' particular medication information needs. To meet the challenges of providing medication information to low-literate English and Spanish speaking older adults, we sought to create individualized, culturally and linguistically inclusive medication education materials for older adults from diverse backgrounds.
Methods: We used a mixed-method design including a systematic review, analysis of existing data, a telephone survey (n=326), and exploratory focus groups stratified by race/ethnicity and language spoken (11 focus groups; n=106) to identify what information about medications older adults need, want to learn, and in what format.
Pharmacologic management of non-cancer pain among nursing home residents.
J Pain Symptom Manage
January 2013
Context: Pain is common in nursing home settings.
Objectives: To describe scheduled analgesic use among nursing home (NH) residents experiencing non-cancer pain and evaluate factors associated with scheduled analgesic use.
Methods: We identified 2508 residents living in one of 185 NHs predominantly from one for-profit chain, with pain recorded on two consecutive Minimum Data Set assessments.
Background: On 31 March 2009, the US Centers for Medicare & Medicaid Services (CMS) provided revised guidance for meeting compliance in the evaluation and management of pain in nursing home residents, known as F-Tag 309.
Objective: The aim of the study was to estimate the extent to which implementation of revisions to the surveyors' interpretive guidelines for F-Tag 309 improved recognition and management of pain among nursing home residents.
Methods: The impact of the revisions to guidance on F-Tag 309 on pain in nursing home residents was investigated.
Background: Although hypoglycemia is a well-recognized complication of type 1 diabetes and insulin treatment in type 2 diabetes, less research exists on hypoglycemia in the large number of patients with type 2 diabetes who are treated with oral antidiabetic agents.
Objective: To identify predictors of hypoglycemia-related emergency department (ED) and outpatient visits in patients with type 2 diabetes.
Methods: We used the 2004-2008 MarketScan database to conduct a nested case-control analysis.
Objectives: To estimate the rate and costs of hypoglycemia in patients with type 2 diabetes.
Study Design: We used a retrospective cohort design to assess the rate and costs of hypoglycemia among working-age patients with type 2 diabetes in the 2004 to 2008 MarketScan database.
Methods: We followed patients from cohort entry to the first instance of hypoglycemia requiring medical intervention (inpatient, emergency department [ED], or outpatient) and calculated incidence rates (IRs), stratifying these estimates by age (18-34, 35-49, 50-64, and 65+ years) and gender.
Background: Hypoglycemia requiring hospitalization remains a serious and costly limitation to treatment of type 2 diabetes with antidiabetic medications.
Objective: We identified risk factors for hypoglycemia hospitalization in patients with type 2 diabetes treated with oral antidiabetic drugs (OADs).
Methods: In the 2004 to 2008 MarketScan database, we identified patients with type 2 diabetes taking OADs with >12 months of enrollment.
Objective: To describe the development of evidence-based electronic prescribing (e-prescribing) triggers and treatment algorithms for potentially inappropriate medications (PIMs) for older adults.
Design: Literature review, expert panel and focus group.
Setting: Primary care with access to e-prescribing systems.
Objectives: To determine the extent to which pain is associated with well-being indices among nursing home residents.
Design: Cross-sectional.
Setting: A total of 185 for-profit nursing homes from 19 states.
While newer antibiotics play a key role in treating methicillin-resistant Staphylococcus aureus (MRSA) infections, knowledge of their real-world clinical impact is limited. We sought to quantify the effectiveness of linezolid compared to that of vancomycin among MRSA-infected patients. This national retrospective cohort study included adult patients admitted to all Veterans Affairs hospitals between January 2002 and June 2008, infected with MRSA, and treated with either linezolid (oral or intravenous [i.
View Article and Find Full Text PDFBackground: In recent years, many state Medicaid programs have implemented preferred drug lists (PDL) to control pharmaceutical costs by generating supplemental rebate revenues and directing providers to the most cost-effective treatments. Two states, Michigan and Vermont, sought approval from the Centers for Medicare and Medicaid Services for supplemental rebates for their Medicaid fee-for-service programs in 2002. Behavioral health medications were largely excluded from PDLs and other managed care initiatives implemented by state Medicaid programs because of significant opposition to any impact on this "vulnerable" population.
View Article and Find Full Text PDFBackground: The risk of adverse events among alcohol-interactive medication users can occur with one standard alcoholic drink. Research on the extent to which this occurs is scant.
Objective: To examine the prevalence and correlates of concurrent alcohol and alcohol-interactive (AI) medication use across different levels of risk for an alcohol-related adverse event in a nationally representative sample of American adults.
Objectives: The objective of this paper was to describe primary care prescribers' perspectives on electronic prescribing drug alerts at the point of prescribing.
Design: We used a mixed-method study which included clinician surveys (web-based and paper) and focus groups with prescribers and staff.
Participants: Prescribers (n = 157) working in one of 64 practices using 1 of 6 e-prescribing technologies in 6 US states completed the quantitative survey and 276 prescribers and staff participated in focus groups.
Study Objectives: To assess the prevalence of dysglycemia (hypoglycemia or hyperglycemia) associated with oral levofloxacin and gatifloxacin therapy in an outpatient setting, and to determine the characteristics of patients who developed dysglycemia while receiving either fluoroquinolone.
Design: Retrospective medical record review.
Setting: Outpatient clinic of a Veterans Affairs teaching hospital.
Objectives: To test the hypothesis that there is little concordance in perceptions of medication-related communication between patients and providers, with providers estimating greater frequency of such discussions than patients; and to determine whether discordance is less apparent among patients who received e-prescriptions.
Study Design: Data are from a convenience sample of 96 providers practicing in 6 states and 1100 of their patients. Twenty-nine practices used e-prescribing, and 3 practices were initiating e-prescribing.
Electronic prescribing technology enables healthcare providers access to more complete information regarding patient's medication history including prescriptions written by other healthcare providers. President Bush has put forth the goal of electronic health records for most Americans by 2014. Yet, regulatory roadblocks may be preventing further progress toward achieving these goals.
View Article and Find Full Text PDFBackground: Survey research focusing on patient safety issues in the nursing home sector poses challenges owing to nursing staff turnover rates, and the adversarial and punitive nature of US nursing home regulation which may promote a negative culture of distrust. Using a patient safety questionnaire, we compared two methods of survey distribution on response rates, respondent sample characteristics, and resident safety ratings. We hypothesized that employees may provide overly positive perceptions when the surveys are distributed on-site as opposed to distribution to employees' homes, as has been reported by studies evaluating patient satisfaction in other settings.
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