Risk Factors for Empiric Treatment Failure in US Female Outpatients with Uncomplicated Urinary Tract Infection: an Observational Study.

Background: Treatment failure (TF) in uncomplicated urinary tract infection (uUTI) increases disease burden and risk of antimicrobial resistance. Identification of risk factors for TF could inform empiric treatment decisions and reduce suboptimal outcomes.

Objective: To evaluate the incidence of TF to empirically prescribed oral antibiotics and identify risk factors for TF in females with uUTI in the United States (US).

A comparison of clinical, utilization, and cost outcomes between oral treatments for multiple sclerosis.

Background: Multiple sclerosis (MS) affects nearly 1 million people in the United States and causes significant disability and economic loss. Among the first available oral MS treatment options, clinical outcome comparisons and associated health care resource utilization are not clearly defined.

Objective: To compare MS outcomes, health care resource utilization, and relative costs across treatment with dimethyl fumarate (DMF), fingolimod (FG), or teriflunomide (TERI) among Medicare Advantage Prescription Drug (MAPD) plan and commercially insured beneficiaries.

HIV preexposure prophylaxis treatment patterns in a national health plan population.

Background: Medication nonadherence diminishes the benefits of preexposure prophylaxis (PrEP) for the 1.2 million Americans at risk for HIV exposure.

Objective: To describe HIV PrEP treatment patterns among Medicare Advantage Prescription Drug (MAPD) plan and commercially insured beneficiaries.

Home versus outpatient hospital intravenous immunoglobulin infusion and health care resource utilization.

Background: Home health care delivery is projected to increase. Intravenous immunoglobulin (IVIG) therapy has high potential to move from the outpatient hospital (OPH) setting to home delivery.

Objective: This study examined the relationship between home and OPH IVIG infusions and health care utilization.

Early vs late filling of new heart failure prescription and its association with avoidable hospital admissions.

Individuals with heart failure (HF) are at increased risk for hospitalization and readmission after discharge. The impact of timing to new prescription filling on avoidable HF hospitalization is understudied in HF management. The Agency of Healthcare Research and Quality identifies HF-related inpatient admissions as potentially avoidable if they could be managed successfully in outpatient settings.

The impact of real-world cardiovascular-related pharmacogenetic testing in an insured population.

Background: Pharmacogenomics is intended to help clinicians provide the right drug to the right patient at an appropriate dose. However, limited evidence of clinical utility has slowed uptake of pharmacogenomic testing (PGT).

Objective: To evaluate the impact of real-world cardiovascular (CV)-related PGT on clinical outcomes, healthcare resource utilisation (HCRU) and cost in a large, heterogeneous population.

Comparative Effectiveness of Rapid-Acting Insulins in Adults with Diabetes.

Background: Although there are a variety of insulin products and new delivery modalities available, the absence of direct clinical and economic comparisons can make treatment planning and formulary decision making difficult. Direct comparisons between insulin aspart and insulin lispro from a large heterogeneous population are not available.

Objective: To assess differences in clinical outcomes, medication adherence, utilization, and total health care costs between aspart and lispro and vial versus pen modalities for administering these short-acting insulin analogs.

Development and Validation of a Predictive Model to Identify Individuals Likely to Have Undiagnosed Chronic Obstructive Pulmonary Disease Using an Administrative Claims Database.

Background: Despite the importance of early detection, delayed diagnosis of chronic obstructive pulmonary disease (COPD) is relatively common. Approximately 12 million people in the United States have undiagnosed COPD. Diagnosis of COPD is essential for the timely implementation of interventions, such as smoking cessation programs, drug therapies, and pulmonary rehabilitation, which are aimed at improving outcomes and slowing disease progression.

A retrospective, matched cohort study of potential drug-drug interaction prevalence and opioid utilization in a diabetic peripheral neuropathy population initiated on pregabalin or duloxetine.

Background: Anticipating and controlling drug-drug interactions (DDIs) in older patients with painful diabetic peripheral neuropaty (pDPN) presents a significant challenge to providers. The purpose of this study was to examine the impact of newly initiated pregabalin or duloxetine treatment on Medicare Advantage Prescription Drug (MAPD) plan pDPN patients' encounters with potential drug-drug interactions, the healthcare cost and utilization consequences of those interactions, and opioid utilization.

Methods: Study subjects required a pregabalin or duloxetine pharmacy claim between 07/01/2008-06/30/2012 (index event), ≥1 inpatient or ≥2 outpatient medical claims with pDPN diagnosis between 01/01/2008-12/31/2012, and ≥12 months pre- and ≥6 post-index enrollment.

Impact of roflumilast on exacerbations of COPD, health care utilization, and costs in a predominantly elderly Medicare Advantage population.

Background: Chronic obstructive pulmonary disease (COPD) exacerbations are associated with declining lung function and health-related quality of life, and increased hospitalization and mortality. Clinical trials often poorly represent the elderly and thus have only partial applicability to their clinical care.

Objective: To compare exacerbations, COPD-related health care utilization (HCU), and costs in a predominantly elderly Medicare COPD population initiated on roflumilast versus those not initiated on roflumilast.

Impact of potential pregabalin or duloxetine drug-drug interactions on health care costs and utilization among Medicare members with fibromyalgia.

Purpose: To examine the impact of newly initiated pregabalin or duloxetine treatment on fibromyalgia (FM) patients' encounters with potential drug-drug interactions (DDIs), the health care cost and utilization consequences of those interactions, and the impact of treatment on opioid utilization.

Patients And Methods: Subjects included those with an FM diagnosis, a pregabalin or duloxetine prescription claim (index event), ≥1 inpatient or ≥2 outpatient medical claims, and ≥12 months preindex and ≥6 postindex enrollment. Propensity score matching was used to help balance the pregabalin and duloxetine cohorts on baseline demographics and comorbidities.

Effects of an adverse-drug-event alert system on cost and quality outcomes in community hospitals.

Purpose: The effects of an adverse-drug-event (ADE) alert system on cost and quality outcomes in community hospitals were evaluated.

Methods: This retrospective observational study evaluated the effects of an ADE alert system in seven hospitals in the Trinity Health network. Outcomes for all inpatients admitted to these hospitals after and one year before the deployment of an ADE alert system were evaluated.

Satisfaction with current health status in patients with a history of acute coronary syndrome.

Objective: To describe satisfaction with current health status in patients with a recent history of an acute coronary syndrome (ACS) event and to determine the association between satisfaction and patient-specific variables.

Research Design And Methods: Patients from an ACS registry who were discharged from a university affiliated hospital over a 3-year period were mailed the study questionnaire.

Main Outcomes Measures: Data included demographics, cardiac-specific measures, and general health status (SF-8 PCS, MCS and the EQ-5D VAS) and health status preference weight (EQ-5D Health Index).

Comparative cost-effectiveness of posaconazole versus fluconazole or itraconazole prophylaxis in patients with prolonged neutropenia.

Purpose: A cost-effectiveness analysis was performed to investigate the financial impact of using posaconazole versus fluconazole or itraconazole prophylaxis in patients with prolonged neutropenia.

Methods: A decision-analytic model was developed from a hospital perspective based on the use of posaconazole versus fluconazole or itraconazole prophylaxis in patients with prolonged neutropenia (i.e.

Cost-effectiveness of quantitative fecal lactoferrin assay for diagnosis of symptomatic patients with ileal pouch-anal anastomosis.

Background And Aims: To assess cost-effectiveness of fecal lactoferrin (FL) as the initial diagnostic approach to symptomatic patients with ileal pouch-anal anastomosis (IPAA).

Methods: Four competing strategies [empiric metronidazole therapy (txMTZ), initial pouch endoscopy with biopsy (testBiop), initial FL assay followed by metronidazole therapy (testFL+MTZ), and initial FL assay followed by pouch endoscopy and biopsy (testFL+Biop)] were modeled in a decision tree.

Results: In the base-case, the average cost per patient was $241 for testFL+MTZ, $251 for txMTZ, $405 for testFL+Biop, and $431 for testBiop.

Effect of pharmacy practice residency training on residents' knowledge of and interest in clinical research.

Purpose: The effect of pharmacy practice residency training on subjectively and objectively assessed research knowledge, skills, and interests of residents was studied.

Methods: A preintervention versus post-intervention design was used. Residency year 2004- 05 residents were administered a validated Web-based survey at the beginning of residency and again at the end of residency.

Evaluation of clinical research knowledge and interest among pharmacy residents: survey design and validation.

Purpose: The development and validation of a survey to describe the research knowledge, attitudes, and skills of pharmacy practice residents are described.

Summary: A survey was drafted to determine if pharmacy practice residency experience and the American Society of Health-System Pharmacists (ASHP)-required project improve the residents' objectively and subjectively assessed research knowledge, to determine if the residency experience and the ASHP-required project affect the residents' attitudes regarding research as a component of their future professional practice, and to subjectively assess the effect of the residency experience and the ASHP-required project on other essential skills, such as problem solving, critical thinking, and time management. An initial questionnaire was developed and underwent content validation testing by clinical pharmacists and faculty, residents, and research fellows.

Patient-reported underuse of prescription medications: a comparison of nine surveys.

Nine national surveys documenting patient underuse of prescription medications were examined to describe the variation and trends in that underuse and identify possible reasons for the substantially different rates that were reported. Underuse includes unfilled prescriptions, delayed therapy, reduced frequency, and lowered dosage. Rates of cost-related patient underuse in the studies ranged from 1.

Gender and perceived severity of cardiac disease: evidence that women are "tougher".

Purpose: Patients' beliefs about their disease may affect their willingness to engage in preventive health behaviors. We sought to determine whether men and women with acute coronary syndrome differ in their perceptions of the severity of cardiac-related illness while controlling for the clinical severity of their condition.

Methods: All patients with acute coronary syndrome discharged from a university hospital during a 3-year period were mailed a questionnaire, and medical records were abstracted.

Perceived work performance of patients who experienced an acute coronary syndrome event.

The objectives of this study were to describe the perceived work performance of patients previously diagnosed with acute coronary syndrome (ACS) and to determine the relationship between patient-specific variables and perceived work performance. This cross-sectional study utilized a mailed survey to all patients discharged from a university affiliated hospital with the diagnosis of ACS during a 3-year period. Perceived work performance was measured using the Work Performance Scale (WPS).

Validation of the EQ-5D in patients with a history of acute coronary syndrome.

Objective: To analyze the construct validity of the EQ-5D in patients with acute coronary syndromes (ACS).

Methods: All ACS-diagnosed patients discharged from a university-affiliated hospital during a 3-year period were mailed a questionnaire that included the EQ-5D and the SF-8. The EQ-5D includes a visual analogue scale (EQ VAS) to measure self-reported current health-status (0-100) and a five-item descriptive system measuring mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.

Depressive symptoms and treatment after acute coronary syndrome.

Background: There is limited data regarding the effects of depression treatment adequacy on the mental component of health-related quality of life in a post-acute coronary syndrome population.

Methods: All patients diagnosed with an acute coronary syndrome and discharged from a university-affiliated hospital during a 3-year period were mailed a survey that included the SF-8, EQ-5D and other self-reported measures of disease and treatment (e.g.

Herbal use among US elderly: 2002 National Health Interview Survey.

Background: Use of herbal products among the elderly is an important concern for healthcare professionals. The presence of polypharmacy and multiple comorbidities places the elderly at high risk for herb-drug and herb-disease interactions. Limited data exist regarding herbal use among the US elderly population.

Suboptimal statin adherence and discontinuation in primary and secondary prevention populations.

Objectives: To compare statin nonadherence and discontinuation rates of primary and secondary prevention populations and to identify factors that may affect those suboptimal medication-taking behaviors.

Design: Retrospective cohort utilizing pharmacy claims and administrative databases.

Setting: A midwestern U.