A Health Plan's Formulary Led To Reduced Use Of Extended-Release Opioids But Did Not Lower Overall Opioid Use.

Many insurers are using formulary design to influence opioid prescribing, but it is unclear if these changes lead to reduced use or just substitution between opioids. We evaluated the effect of a new prior authorization process implemented in July 2015 for extended-release (ER) oxycodone by Blue Shield of California. Compared to other commercially insured Californians, among 880,000 Blue Shield enrollees, there was a 36 percent drop in monthly rates of ER opioid initiation relative to control-group members, driven entirely by decreases in ER oxycodone initiation and without any substitution toward other ER opioids.

Opioid prescribing for chronic pain in a community-based healthcare system.

Objectives: We sought to evaluate opioid prescribing in an ambulatory setting among patients with noncancer chronic pain (CP).

Study Design: Cross-sectional analysis.

Methods: We identified patients with at least 2 CP encounters at least 30 days apart in 2012 in the electronic health records of a community-based healthcare delivery system in northern California.

Patient characteristics and healthcare utilization of a chronic pain population within an integrated healthcare system.

Objectives: We sought to characterize the chronic pain (CP) population and healthcare utilization across types of CP within a community-based healthcare system.

Study Design: Cross-sectional study of electronic health records data from 2012.

Methods: Patients 18 years or older with at least 2 encounter diagnoses for CP conditions in 2012 were included in the study.

Pharmacist-led medication management program within a patient-centered medical home.

Purpose: The impact of a clinical pharmacist-led medication management program (MMP) within a patient-centered medical home (PCMH) was evaluated.

Methods: This retrospective analysis included patients in Sutter Health's electronic health records who (1) were seen by the MMP clinical pharmacist within the PCMH (MMP cohort), (2) were within the PCMH but were not referred to the MMP pharmacist (PCMH cohort), or (3) received usual care at two non-PCMH primary care clinics (usual care cohort). Patients were matched on their propensity for receiving medication management.

Multivariate analysis of factors associated with persistent colesevelam treatment among patients with hypercholesterolemia.

Background: Persistent treatment with lipid-lowering therapies is important for achieving optimal clinical outcomes. To date, no study has evaluated the real-world use of colesevelam and the factors associated with persistent colesevelam treatment.

Objective: The primary objective of this study was to examine patient demographic and characteristics associated with persistent colesevelam treatment in real-world clinical practice.

Colesevelam in the treatment of hypercholesterolemia and hyperglycemia: a retrospective analysis from an ambulatory care medical network.

Objective: To examine outcomes associated with colesevelam treatment among patients with hypercholesterolemia in real-world clinical practice.

Methods: This analysis was conducted as a retrospective, observational cohort study in an ambulatory-care medical network in Northern California. Patients with orders for colesevelam were identified in the electronic health record between January 2004 and December 2011.

Disparities in adherence to and persistence with antihypertensive regimens: an exploratory analysis from a community-based provider network.

Despite the availability of effective antihypertensive therapies, adherence to and persistence with treatment is suboptimal. As such, there is a need to better understand factors associated with adherence and persistence, such as race/ethnicity. In a retrospective, exploratory analysis of 51,772 hypertensive adult subjects identified in the electronic medical record, we examined medication possession ratio and proportion of days covered as proxies for adherence and persistence, respectively.

Disparities in blood pressure control within a community-based provider network: an exploratory analysis.

Background: Despite treatment for hypertension, blood pressure (BP) remains uncontrolled in many individuals. Identification of patterns in BP control may inform strategies to improve treatment and optimize health outcomes.

Objective: To examine patterns in BP control among individuals receiving antihypertensive treatment in a diverse, community-based provider network.

Effects of increasing doses of atorvastatin on the atherogenic lipid subclasses commonly associated with hypertriglyceridemia.

The increased cardiovascular risk associated with hypertriglyceridemia is thought to be due in part to high levels of triglyceride (TG)-rich lipoproteins and small dense low-density lipoprotein (LDL). In this post hoc analysis, effects of increasing doses of atorvastatin (10, 20, 40, and 80 mg) on atherogenic lipid subclasses commonly associated with hypertriglyceridemia were evaluated in 191 men and women who were candidates for lipid-lowering therapy and had baseline TG levels >200 mg/dl (2.3 mmol/L).