Objectives: To evaluate the association of state-level policies on receipt of opioid regimens informed by Centers for Disease Control and Prevention (CDC) morphine milligram equivalent (MME)/day recommendations.
Design: A retrospective cohort study of new chronic opioid users (NCOUs).
Setting: Commercially insured plans across the United States using IQVIA PharMetrics® Plus for Academics database with new chronic use between January 2014 and March 2015.
Objective: To evaluate the impact of recent changes to the Centers for Disease Control and Prevention (CDC) morphine milligram equivalent (MME)/day threshold recommendations on healthcare utilization.
Design: A retrospective cohort study of new chronic opioid users (NCOUs).
Setting: Commercially insured plans across the United States using IQVIA PharMetrics® Plus for Academics database with new use between January 2014 and March 2015.
Background: Following the identification of a late mortality signal, the Food and Drug Administration (FDA) convened an advisory panel that concluded that additional clinical study data are needed to comprehensively evaluate the late mortality signal observed with the use of drug-coated balloons (DCB) and drug-eluting stent (DES). The objective of this review is to (1) identify and summarize the existing clinical and cohort studies assessing paclitaxel-coated DCBs and DESs, (2) describe and determine the quality of the available data sources for the evaluation of these devices, and (3) present methodologies that can be leveraged for proper signal discernment within available data sources.
Methods: Studies and data sources were identified through comprehensive searches.
Background: Maternal misuse of prescription opioids and illicit drugs such as, heroin and non-pharmaceutical fentanyl analogs has increased in the last 2 decades and one in 5 women reported misuse of opioids. Medications for opioid use disorder (MOUD) are recommended for treating pregnant women with opioid use disorder (OUD). MOUD is effective in reducing cravings and negative outcomes, yet treatment is underutilized and varies in integration and intensity of resources across health systems.
View Article and Find Full Text PDFMaternal mortality rates in the USA remain high, with persistent racial and socioeconomic disparities. We identified 207,016 hospital admissions for pregnant women in Maryland, from 2017 to 2019. Logistic regression was used to identity factors associated with maternal death.
View Article and Find Full Text PDFBackground: The effectiveness of combined atherectomy and stenting relative to use of each procedure alone for the treatment of lower extremity peripheral artery disease has not been evaluated.
Aims: The objective of this study was to evaluate the short- and long-term major adverse limb event (MALE) following the receipt of stenting, atherectomy, and the combination of stent and atherectomy.
Methods: A retrospective cohort of patients undergoing atherectomy, stent, and combination stent atherectomy for lower extremity peripheral artery disease was derived from the Vascular Quality Initiative (VQI) data set.
J Am Pharm Assoc (2003)
April 2023
Background: Fatal drug overdoses, now primarily driven by illicit opioids like fentanyl, continue to increase in the United States, reflecting a growing need for prevention and treatment strategies. Preventive interventions have primarily focused on curbing opioid prescribing, and treatment strategies target individuals. However, little is known about the broader social context surrounding these individuals.
View Article and Find Full Text PDFJ Health Care Poor Underserved
November 2022
Introduction: The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected certain high-risk populations, including those with underlying chronic illnesses and those who are socioeconomically disadvantaged.
Methods: Our study evaluated county-level rates of fully vaccinated populations after classifying counties based on rates of non-communicable diseases (NCDs) and socioeconomic inequities below the 25th percentile of overall distribution of counties for each measure as low, counties above the 75th percentile as high, and all other counties as medium.
Results: Counties with higher rates of non-communicable diseases and socioeconomic disparities had lower COVID-19 vaccination coverage than did counties with lower rates of non-communicable diseases and socioeconomic disparities.
BMJ Surg Interv Health Technol
August 2022
Objectives: Objective performance criteria (OPC) may serve as a tool to expedite the approval process and continue active surveillance of class III medical devices. Thus far, published guidance on the creation of OPC has been clinical area-specific. This study aimed to capture reflections from key stakeholders on the creation of OPC that may serve as a precursor for a formalized conceptual framework within the USA.
View Article and Find Full Text PDFPurpose: To compare the predictive ability of mapping algorithms derived using cross-sectional and longitudinal data.
Methods: This methodological assessment used data from a randomized controlled noninferiority trial of patients with low-risk prostate cancer, conducted by NRG Oncology (ClinicalTrials.gov identifier: NCT00331773), which examined the efficacy of conventional schedule versus hypofractionated radiation therapy (three-dimensional conformal external beam radiation therapy/IMRT).
Maryland expanded its "Statewide Naloxone Standing Order" (NSO) in 2017 to eliminate training and prescription requirements for obtaining naloxone, improve naloxone access, help reverse opioid overdose, and reduce overdose fatality rates. To assess the change in the trends of fatal opioid overdose rates following the expansion of the Naloxone Standing Order (eNSO) and its association with the social determinants of health (SDoH). Data on overdose deaths and SDoH from 2015-2019 was collected and analyzed using interrupted time series and multivariate Poisson regression models to study the change in trends and the associations.
View Article and Find Full Text PDFPurpose: The Expanded Prostate Cancer Index Composite (EPIC) is the most commonly used patient reported outcome (PRO) tool in prostate cancer (PC) clinical trials, but health utilities associated with the different health states assessed with this tool are unknown, limiting our ability to perform cost-utility analyses. This study aimed to map EPIC tool to EuroQoL-5D-3L (EQ5D) to generate EQ5D health utilities.
Methods And Materials: This is a secondary analysis of a prospective, randomized non-inferiority clinical trial, conducted between 04/2006 and 12/2009 at cancer centers across the United States, Canada, and Switzerland.
Background: Medications for opioid use disorder (MOUD) are recommended with adjuvant behavioral therapies, counseling, and other services for comprehensive treatment of maternal opioid use disorder. Inadequate access to treatment, lack of prescribing providers and complex delivery models are among known barriers to care. Multi-disciplinary provider input can be leveraged to comprehend factors that facilitate or inhibit treatment.
View Article and Find Full Text PDFIntroduction: Patients with atherosclerotic cardiovascular disease (ASCVD), especially those with recent (< 1 year) acute coronary syndrome (ACS), are at high risk for recurrent cardiovascular events. This risk can be reduced by lowering low-density lipoprotein cholesterol (LDL-C) levels. A comprehensive meta-analysis on the LDL-C-lowering efficacy of ezetimibe is lacking.
View Article and Find Full Text PDFJ Subst Use
July 2019
Objectives: To identify and define potential positive and negative factors in patient experiences and patient-provider interactions that are associated with the pursuit and maintenance of treatment by those suffering from substance use disorders (SUD).
Methods: Two focus groups with patients in treatment for SUD were performed. The focus groups focused on questions aimed at mapping factors associated with initiating and maintaining treatment along the transtheoretical model of change.
Purpose: Practice transformation in primary care is a movement toward data-driven redesign of care, patient-centered care delivery, and practitioner activation. A critical requirement for achieving practice transformation is availability of tools to engage practices.
Methods: A total of 48 practices with 109 practice sites participate in the Garden Practice Transformation Network in Maryland (GPTN-Maryland) to work together toward practice transformation and readiness for the Quality Payment Program implemented by the Centers for Medicare & Medicaid Services.
J Manag Care Spec Pharm
August 2019
Background: There is a paucity of studies validating budget impact models. The lack of such studies may contribute to the underuse of budget impact models by payers in formulary decision making.
Objective: To assess the face validity, internal verification, and predictive validity of a previously published model that assessed the budgetary impact of antidiabetic formulary changes.
Importance: Inadequate treatment of opioid use disorder (OUD) in pregnant women increases the risk of life-threatening consequences on maternal and fetal outcomes. Untreated OUD during pregnancy is associated with higher rates of adverse outcomes among newborns.
Objective: To examine the variation in the prevalence of OUD and the use of medication-assisted treatment among commercially insured pregnant women according to region and state legislature.
Background: Traditional budget impact models predict the financial consequences of a new drug entering the market. This study provides an example of applying the budget impact framework to a new research question of interest to managed care organizations-what is the budget impact of our formulary and utilization management (UM) policy changes?
Objective: To predict the 3-year annual budgetary impact of TRICARE's antidiabetic formulary and UM policy changes using TRICARE claims data.
Methods: A budget impact model was built in Microsoft Excel using health plan claims data for a 3-year time horizon.
Background: Addiction is one of the most rapidly growing epidemics that currently plagues nations around the world. In the United States, it has cost the government more than US $700 billion a year in terms of health care and other associated costs and is also associated with serious social, physical, and mental consequences. Increasing efforts have been made to tackle this issue at different levels, from primary prevention to rehabilitation across the globe.
View Article and Find Full Text PDFCurr Pharm Teach Learn
September 2018
Introduction: The literature is limited related to school of pharmacy (SOP) characteristics that may impact a student's residency match success. Given the paucity of information, the aim of our study was to examine the association between multiple school specific characteristics and Post-Graduate Year 1 (PGY1) residency match rate.
Methods: PGY1 residency match data and SOP specific characteristics were obtained.