Tyrosine Kinase Inhibitors and the Relationship With Adherence, Costs, and Health Care Utilization in Commercially Insured Patients With Newly Diagnosed Chronic Myeloid Leukemia: A Retrospective Claims-Based Study.

Objective: To examine the association among tyrosine kinase inhibitor (TKI) out-of-pocket costs, adherence, and health care costs and utilization in a large group of commercially insured patients with chronic myeloid leukemia (CML).

Materials And Methods: Patients with CML aged 18 to 64 years were identified using IBM MarketScan Commercial Database between April 1, 2011 and December 31, 2014. Patients were required to be continuously enrolled 3 months before and 12 months after TKI (imatinib, dasatinib, or nilotinib) initiation.

The economic burden of caregiving in epilepsy: An estimate based on a survey of US caregivers.

Objective: The burden of caregiving for persons with epilepsy (PWEs) has not been examined previously in the United States. We assessed the clinical impact and direct and indirect economic costs for caregivers of PWEs.

Methods: An internet survey of 500 caregivers of PWEs was conducted from May to July 2015 using a combination of validated instruments and questions designed specifically for this survey.

Tyrosine Kinase Inhibitors Initiation, Cost Sharing, and Health Care Utilization in Patients with Newly Diagnosed Chronic Myeloid Leukemia: A Retrospective Claims-Based Study.

Background: For newly diagnosed chronic myeloid leukemia (CML) patients, early access to tyrosine kinase inhibitors (TKIs) is a consistent predictor of adherence and optimal response. The expense of targeted therapies, however, may result in high out-of-pocket costs for initiating therapy that could be a barrier to starting treatment.

Objective: To examine the association between TKI out-of-pocket costs, initiation, and health care utilization and costs among patients who initiated TKI within 12 months after initial CML diagnosis.

Addition of mHealth (mobile health) for family planning support in Kenya: disparities in access to mobile phones and associations with contraceptive knowledge and use.

Background: Recently mobile health (mHealth) has been implemented in Kenya to support family planning. Our objectives were to investigate disparities in mobile phone ownership and to examine the associations between exposure to family planning messages through mHealth (stand-alone or combined with other channels such as public forums, informational materials, health workers, social media and political/religious/community leaders' advocacy) and contraceptive knowledge and use.

Methods: Logistic and Poisson regression models were used to analyze the 2014 Kenya Demographic and Health Survey.

The primary prevention of epilepsy: A report of the Prevention Task Force of the International League Against Epilepsy.

Among the causes of epilepsy are several that are currently preventable. In this review, we summarize the public health burden of epilepsy arising from such causes and suggest priorities for primary epilepsy prevention. We conducted a systematic review of published epidemiologic studies of epilepsy of 4 preventable etiologic categories-perinatal insults, traumatic brain injury (TBI), central nervous system (CNS) infection, and stroke.

Rationale and Design of a Statewide Cohort to examine efficient resource utilization for patients with Intracerebral hemorrhage (EnRICH).

Background: Intracerebral hemorrhage is a devastating disease with no specific treatment modalities. A significant proportion of patients with intracerebral hemorrhage are transferred to large stroke treatment centers, such as Comprehensive Stroke Centers, because of perceived need for higher level of care. However, evidence of improvement in patient-centered outcomes for these patients treated at larger stroke treatment centers as compared to community hospitals is lacking.

Demographic and Clinical Correlates of Seizure Frequency: Findings from the Managing Epilepsy Well Network Database.

Background And Purpose: Epilepsy is a chronic neurological disease that represents a tremendous burden on both patients and society in general. Studies have addressed how demographic variables, socioeconomic variables, and psychological comorbidity are related to the quality of life (QOL) of people with epilepsy (PWE). However, there has been less focus on how these factors may differ between patients who exhibit varying degrees of seizure control.

Oncologic emergencies in a cancer center emergency department and in general emergency departments countywide and nationwide.

Background: Although cancer patients (CPs) are increasingly likely to visit emergency department (ED), no population-based study has compared the characteristics of CPs and non-cancer patients (NCPs) who visit the ED and examined factors associated with hospitalization via the ED. In this study, we (1) compared characteristics and diagnoses between CPs and NCPs who visited the ED in a cancer center or general hospital; (2) compared characteristics and diagnoses between CPs and NCPs who were hospitalized via the ED in a cancer center or general hospital; and (3) investigated important factors associated with such hospitalization.

Methods And Findings: We analyzed patient characteristic and diagnosis [based on International Classification of Diseases-9 (ICD-9) codes] data from the ED of a comprehensive cancer center (MDACC), 24 general EDs in Harris County, Texas (HCED), and the National Hospital Ambulatory Medical Care Survey (NHAMCS) from 1/1/2007-12/31/2009.

m-Health Policy Readiness and Enabling Factors: Comparisons of Sub-Saharan Africa and Organization for Economic Cooperation and Development Countries.

Background: As an innovative solution to poor access to care in low- and middle-income countries (LMICs), m-health has gained wide attention in the past decade.

Introduction: Despite enthusiasm from the global health community, LMICs have not demonstrated high uptake of m-health promoting policies or public investment.

Materials And Methods: To benchmark the current status, this study compared m-health policy readiness scores between sub-Saharan Africa and high-income Organization for Economic Cooperation and Development (OECD) countries using an independent two-sample t test.

Innovating patient care delivery: DSRIP's interrupted time series analysis paradigm.

Introduction: Adoption of Medicaid Section 1115 waiver is one of the many ways of innovating healthcare delivery system. The Delivery System Reform Incentive Payment (DSRIP) pool, one of the two funding pools of the waiver has four categories viz. infrastructure development, program innovation and redesign, quality improvement reporting and lastly, bringing about population health improvement.

Clinic-Based Mobile Health Decision Support to Enhance Adult Epilepsy Self-Management: An Intervention Mapping Approach.

Introduction: Epilepsy is a neurological disorder involving recurrent seizures. It affects approximately 5 million people in the U.S.

The Managing Epilepsy Well Network:: Advancing Epilepsy Self-Management.

Epilepsy, a complex spectrum of disorders, affects about 2.9 million people in the U.S.

Factors Associated With the Likelihood of Hospitalization Following Emergency Department Visits for Behavioral Health Conditions.

Objectives: Behavioral health-related emergency department (ED) visits have been linked with ED overcrowding, an increased demand on limited resources, and a longer length of stay (LOS) due in part to patients being admitted to the hospital but waiting for an inpatient bed. This study examines factors associated with the likelihood of hospital admission for ED patients with behavioral health conditions at 16 hospital-based EDs in a large urban area in the southern United States.

Methods: Using Andersen's Behavioral Model of Health Service Use for guidance, the study examined the relationship between predisposing (characteristics of the individual, i.

Primary Care Availability, Safety Net Clinics, and Health Insurance Coverage: The Association of These Access Factors With Preventable Hospitalizations.

The objective of the study was to examine the relationship between physician/safety net availability and health insurance coverage and preventable hospitalizations (PHs) in nonelderly adults in an urban area. Preventable conditions (PHs) were identified for nonelderly adults in Harris County using the Texas Health Care Information Collection hospital database. Multivariable logistic regression models examined the association of health insurance and patient proximity to physicians and safety net clinics with the risk of a PH.

Delays in Seeking Health Care: Comparison of Veterans and the General Population.

Objectives: Recent reports of delays in receiving care among U.S. Veterans have received national attention.

Predictors of psychiatric readmission among patients with bipolar disorder at an academic safety-net hospital.

Objective: Even with treatment, approximately one-third of patients with bipolar disorder relapse into depression or mania within 1 year. Unfavorable clinical outcomes for patients with bipolar disorder include increased rates of psychiatric hospitalization and functional impairment. However, only a few studies have examined predictors of psychiatric hospital readmission in a sample of patients with bipolar disorder.

The direct cost of epilepsy in the United States: A systematic review of estimates.

Objective: To develop estimates of the direct cost of epilepsy in the United States for the general epilepsy population and sub-populations by systematically comparing similarities and differences in types of estimates and estimation methods from recently published studies.

Methods: Papers published since 1995 were identified by systematic literature search. Information on types of estimates, study designs, data sources, types of epilepsy, and estimation methods was extracted from each study.

Newer antiepileptic drug use and other factors decreasing hospital encounters.

A retrospective analysis was conducted in one claims database and was confirmed in a second independent database (covering both commercial and government insurance plans between 11/2009 and 9/2011) for the understanding of factors influencing antiepileptic drug (AED) use and the role of AEDs and other health-care factors in hospital encounters. In both datasets, epilepsy cases were identified by AED use and epilepsy diagnosis coding. Variables analyzed for effect on hospitalization rates were as follows: (1) use of first-generation AEDs or second-generation AEDs, (2) treatment changes, and (3) factors that may affect AED choice.

Survival Benefits of Treatment Access Among Underserved Breast Cancer Patients Diagnosed Through the Texas Breast and Cervical Cancer Services Program.

Purpose: The Texas Breast and Cervical Cancer Services (BCCS) program was established to address socioeconomic disparities in breast and cervical cancer screening and survival. This study examined the impact of the program on treatment and survival of breast cancer patients.

Methods: A retrospective analysis was performed using the Texas Cancer Registry data linked to the BCCS program data.

Impact of the 2011 heat wave on mortality and emergency department visits in Houston, Texas.

Background: Heat waves have been linked to increased risk of mortality and morbidity, and are projected to increase in frequency and intensity in a changing climate. Houston and other areas in Texas experienced an exceptional heat wave in the summer of 2011 producing the hottest August on record. This study aims to assess the health-related impact of this heat wave.

Expanding the efficacy of Project UPLIFT: Distance delivery of mindfulness-based depression prevention to people with epilepsy.

Objective: Depression affects about 16% of the U.S. population over a lifetime.

Physician report of industry gifts and quality of care.

Background: Physician financial conflict of interest is a concern in the delivery of medicine because of its possible influence on the cost and the quality of patient care. There has been an extensive discussion of the ethical, economic, and legal aspects of this issue but little direct empirical evidence of its magnitude or effects.

Methodology: A nationally representative survey (n = 4,720) was used to empirically examine physician self-report of receipt of financial gifts from the pharmaceutical and medical devices industry and its association with their ability to provide quality care.

Breast cancer stage at diagnosis among medically underserved women screened through the Texas Breast and Cervical Cancer Services.

The Texas Breast and Cervical Cancer Services (BCCS) program was established to address the socioeconomic disparities in stage at diagnosis and outcomes among breast cancer patients. This study examines the impact of Texas BCCS on stage at diagnosis among low socioeconomic status (SES) breast cancer patients. This is a retrospective analysis of women aged 40-64 years who were screened and diagnosed with breast cancer through the Texas BCCS program (participants) as compared with similar women living in low-SES census tracts and diagnosed outside the program (comparison group) during 1995-2008.

Surveillance of epilepsy and prevention of epilepsy and its sequelae: lessons from the Institute of Medicine report.

Purpose Of Review: The Institute of Medicine's report, Epilepsy across the Spectrum: Promoting Health and Understanding contains two recommendations for increased epilepsy surveillance and one recommendation on prevention in epilepsy. Evidence supporting these recommendations and the information that can be gained from them is reviewed.

Recent Findings: Existing epilepsy surveillance data are inadequate to address factors such as seizure type, syndrome, socioeconomic status, and race/ethnicity in large representative populations.