Patterns of Care in Patients with Metastatic Renal Cell Carcinoma Among a U.S. Payer Population with Commercial or Medicare Advantage Membership.

Background: Several systemic therapies are now approved for first- and second-line treatment of metastatic renal cell carcinoma (mRCC). Although the National Comprehensive Cancer Network (NCCN) guidelines offer physicians evidence-based recommendations for therapy, there are few real-world studies to help inform the utilization of these agents in clinical practice.

Objectives: To (a) describe the patterns of use associated with systemic therapies for mRCC among Humana members in the United States diagnosed with mRCC, (b) assess consistency with the NCCN guidelines for treatment, and (c) to describe the initial first-line therapy regimen by prescriber specialty and site of care.

Persistence and compliance with pazopanib in patients with advanced renal cell carcinoma within a U.S. administrative claims database.

Background: Pazopanib is an oral tyrosine kinase inhibitor with demonstrated efficacy and tolerability in patients with advanced renal cell carcinoma (RCC).

Objective: To examine pazopanib persistence and compliance (adherence) and other drug utilization patterns in both treatment-naïve (first-line) patients and those previously treated with RCC therapy in the real-world setting. Key factors affecting persistence and compliance were also explored.

Costs Associated with Intravenous Cancer Therapy Administration in Patients with Metastatic Soft Tissue Sarcoma in a US Population.

Background. The most common chemotherapies in metastatic soft tissue sarcoma (mSTS) require intravenous (IV) administration. This often requires patients to make multiple outpatient visits per chemotherapy cycle, possibly impeding patients' daily activities and increasing caregiver burden and medical costs.

Pediatricians' self-reported role in treating children and adolescents with major depressive disorder: a national random survey.

Objective: Major depressive disorder (MDD) is a serious US public health problem for children and adolescents. This study explored pediatricians' self-reported role in treating children and adolescents with DSM-IV-TR MDD after the 2004 US Food and Drug Administration black-box warning.

Method: A national random sample of pediatricians (N = 2,000) was surveyed from the beginning of November 2007 through the end of January 2008, with a usable response rate of 22.

Child psychiatrists' self-reported treatment and monitoring of children and adolescents with major depressive disorder.

Objective: Major depressive disorder (MDD) is a serious U.S. public health problem for children and adolescents.

Patterns of cervical cancer screening, diagnosis, and follow-up treatment in a state Medicaid fee-for-service population.

Despite being a screening-amenable cancer, cervical cancer is the third most common genital cancer among white women and the most common among African American women. The study objective was to use administrative claims data for CC disease surveillance among recipients enrolled in a state Medicaid fee-for-service (FFS) program. West Virginia (WV) Medicaid FFS administrative claims data for female recipients aged 21-64 years from 2003 to 2008 were used for this study.

Exenatide BID and liraglutide QD treatment patterns among type 2 diabetes patients in Germany.

Objectives: This study evaluated patient and prescriber characteristics, treatment patterns, average daily dose (ADD), and glycemic control of patients initiating glucagon-like peptide 1 (GLP-1) receptor agonists in Germany.

Methods: The LifeLink™ EMR-EU database was searched to identify patients initiating exenatide twice daily (BID) or liraglutide once daily (QD) during the index period (January 1, 2009-April 4, 2010). Eligible patients had ≥ 180 days pre-index history, ≥ 90 days post-index follow-up, and a pre-index type 2 diabetes diagnosis.

Exenatide BID Observational Study (ExOS): results for primary and secondary endpoints of a prospective research study to evaluate the clinical effectiveness of exenatide BID use in patients with type 2 diabetes in a real-world setting.

Objective: The Exenatide BID Observational Study (ExOS) was designed to evaluate the clinical effectiveness of exenatide BID use in patients with type 2 diabetes (T2D) in a real-world clinical practice setting in the United States.

Methods: Patients were enrolled from 74 practice sites from 9/2007 through 1/2009 and followed for 12 months. The primary effectiveness endpoint was achieving or maintaining hemoglobin A1C of ≤7.

Treatment of metastatic renal carcinoma patients with the combination of gemcitabine, capecitabine and bevacizumab at a tertiary cancer centre.

Objective: • To investigate the effect of combining gemcitabine plus capecitabine (GX) with bevacizumab (A) in patients with metastatic RCC previously treated with cytokines and targeted agents.

Methods: • The combination of GX + A was evaluated in patients with metastatic RCC using institutional databases. • Data included demographics, previous therapies, number of metastatic sites, Memorial Sloan-Kettering Cancer Center risk stratification variables, and previous nephrectomy status.

Exenatide bid observational study (ExOS): baseline population characteristics of a prospective research study to evaluate the clinical effectiveness of exenatide bid use in patients with type 2 diabetes in a real-world setting.

Objectives: To describe the Exenatide Observational Study (ExOS) and patients initiating exenatide therapy in a real-world clinical practice setting.

Methods: ExOS is a prospective, single-arm, multicenter, observational study to assess the effectiveness of up to 24 months of exenatide therapy in patients with type 2 diabetes (T2D). Patients with T2D ≥18 years of age, who initiated exenatide therapy, were eligible.

Disparities in outpatient antidepressant prescribing patterns and determinants of resource utilization at a tertiary care cancer center.

Our objective was to assess the prevalence of use of different classes of antidepressants, prescribing patterns, and determinants of exposure to specific types of antidepressants and resource utilization at a comprehensive cancer center from 2001 to 2006. Data were collected from the institution's outpatient pharmacy database and cross-referenced with the institution's electronic medical record system. Data collected included demographic characteristics, cancer diagnosis, comorbidities, prescribing physician and service, type and number of antidepressant prescriptions, and resource utilization.

Economic evaluation of four angiotensin II receptor blockers in the treatment of hypertension.

Objective: To evaluate the cost effectiveness of achieving JNC 7 blood pressure goals with angiotensin II receptor blockers (ARBs).

Research Design And Methods: Cost effectiveness of olmesartan, losartan, valsartan, and irbesartan was compared with real world patient chart and claims data from a large US health plan. Patients 18 and older with >or=2 claims for an ARB between May 1, 2002 and December 31, 2005 were identified from the claims database.

Evaluation of medication compliance in patients on antidepressants at an outpatient tertiary cancer center setting.

Objective: The purpose is to evaluate antidepressant compliance in a cancer population at a tertiary cancer center and to determine if there are covariates of importance in predicting the level of compliance in the study population.

Methods: Patients who received at least three prescriptions covering parts of each month for a continuous 6-month period with at least one of the months being in 2006 from a tertiary cancer center were identified as the prevalent population of interest for this retrospective study. Data collected included demographics, cancer and co-morbid diagnoses, and compliance to antidepressant medication using medication possession ratio (MPR) by patient, medication class, and individual agents.

Estimation of a valuation function for a diabetes mellitus-specific preference-based measure of health: the Diabetes Utility Index.

Preference-based measures of health (PBMH) provide 'preference' or 'utility' weights that enable the calculation of QALYs for the economic evaluations of interventions. The Diabetes Utility Index (DUI) was developed as a brief, self-administered, diabetes mellitus-specific PBMH that can efficiently estimate patient-derived health state utilities. To describe the development of the valuation function for the DUI, and to report the validation results of the valuation function.

Impact of changes in reimbursement policies and institutional practice algorithm for utilization of erythropoietic-stimulating agents on treatment patterns and costs in anemic lymphoma patients.

Purpose: The objective of this study was to assess the impact of a new evidence-based institutional practice algorithm on the patterns and costs of treatment of chemotherapy-induced anemia (CIA) in lymphoma patients prescribed erythropoietic-stimulating agents (ESAs).

Methods: The study design was retrospective, with a historical control group. Patient demographic data, clinical data (including chemotherapy and hemoglobin values), and cost data were extracted from patient medical charts and institutional databases.

Rasch analysis informed the development of a classification system for a diabetes-specific preference-based measure of health.

Objective: To develop a classification system (CS) for a diabetes-specific preference-based measure of health titled the Diabetes Utility Index (DUI).

Study Design And Setting: Factor analysis of the Audit of Diabetes-Dependent Quality-of-Life (ADDQoL) items (n=385) identified plausible attributes. An expert panel provided qualitative input, including additional items.

Using the theory of reasoned action to determine physicians' intention to measure body mass index in children and adolescents.

Background: Over the past few decades, childhood obesity has become a major public health issue in the United States. Numerous public and professional organizations recommend that physicians periodically screen for obesity in children and adolescents using the body mass index (BMI). However, studies have shown that physicians infrequently measure BMI in children and adolescents.

Smoking behaviors among cancer survivors: an observational clinical study.

Purpose: Smoking is a well-recognized risk factor for several cancers including cancers of the lung, bladder, and head and neck. Studies have shown that smoking can adversely affect the outcomes of different modalities of cancer treatment. This study examines smoking behaviors among cancer survivors to collect information necessary to create successful smoking cessation interventions.

Persistence, adherence, and switch rates among extended-release and immediate-release overactive bladder medications in a regional managed care plan.

Background: Pharmacotherapy constitutes an important adjunct to behavioral therapy for the treatment of overactive bladder (OAB). Tolterodine and oxybutynin are commonly prescribed drugs for OAB treatment that exert their beneficial effect by suppressing bladder muscle contractions. However, high discontinuation rates have been observed for these drugs in clinical trials, as well as in real-world settings, in part due to adverse effects.

Comparing adherence to and persistence with antipsychotic therapy among patients with bipolar disorder.

Background: Medication nonadherence is a significant problem among patients with bipolar disorder.

Objective: To compare adherence and persistence among patients with bipolar disorder initiated on antipsychotics in a state Medicaid system over a 12 month follow-up period.

Methods: Claims data for patients with bipolar disorder from a de-identified Medicaid database were examined.

Comparative economic analysis of aromatase inhibitors and tamoxifen in the treatment of hormone-dependent breast cancer.

Within the past 2 years three separate groups reported marked improvements in relapse-free survival when trastuzumab was added to adjuvant chemotherapy in patients with HER2-overexpressing breast cancer. Notwithstanding the significance of this molecular target, the discovery of the estrogen receptor (ER) may be of even greater importance. Although tamoxifen has long been considered the hormonal therapy of choice for patients with estrogen-responsive breast cancer, accumulating clinical data suggest the new generation of aromatase inhibitors (AIs) is more effective and less toxic.

Quality of life, health status and clinical outcomes in Type 2 diabetes patients.

This study examines relationships between patient reported outcomes (PROs) and clinical outcomes in Type 2 diabetes mellitus (T2DM). Patients at the outpatient clinics of a university hospital completed measures of generic health status (SF-12), diabetes-specific quality of life (Audit of Diabetes Dependent Quality of Life - ADDQoL), and depressive symptoms (Center for Epidemiologic Studies Depression - CES-D). Patient reported data were merged with a retrospective collection of clinical and utilization data, including HbA1C, from electronic medical records.

Use of tumor necrosis factor inhibitors in rheumatoid arthritis: a national survey of practicing United States rheumatologists.

Objectives: To determine the prescribing practices, laboratory monitoring protocols, and perceived barriers of United States rheumatologists in prescribing tumor necrosis factor (TNF) inhibitors in rheumatoid arthritis (RA).

Methods: A survey questionnaire was mailed to 1970 rheumatologists who were randomly selected from a national sample of 3008 rheumatologists. A one-page non-response questionnaire was mailed to approximately 200 randomly selected non-responding rheumatologists to assess non-response bias.