Evaluating catheter complications and outcomes in patients receiving home parenteral nutrition.

Rationale, Aims And Objectives: We describe catheter complications and outcomes in patients who received home parenteral nutrition (HPN) therapy.

Methods: Retrospective chart data were obtained from Boston Home Infusion agency that provided HPN therapy to 212 patients [International Classification of Diseases, 9th revision (ICD-9) codes: gastrointestinal (GI)-related disorders and oncology] between 1 January 2005 and 30 September 2011.

Results: Of the 163 patients who represented 19104 home-catheter days, 19 (11.

Comparing patient preferences and healthcare provider recommendations with the pen versus vial-and-syringe insulin delivery in patients with type 2 diabetes.

Objectives: This study aimed to examine healthcare provider (HCP) recommendations and patient preferences for the insulin pen versus vial-and-syringe in patients with type 2 diabetes mellitus (T2DM) and to assess clinical end points and safety outcomes.

Subjects And Methods: Using a randomized, open-label, crossover design, in total, 405 insulin-naive adults with T2DM from 60 centers received basal insulin glargine in one of two device treatment sequences (2 weeks of pen followed by 2 weeks of vial-and-syringe, or vice versa). The primary end point, patient device preference, was evaluated at Week 4 (end of the crossover period) using the Insulin Injection Preference Questionnaire.

Development of a men's Preference for Testosterone Replacement Therapy (P-TRT) instrument.

Background: This study used a standard research approach to create a final conceptual model and the Preference for the Testosterone Replacement Therapy (P-TRT) instrument.

Methods: A discussion guide was developed from a literature review and expert opinion to direct one-on-one interviews with participants who used testosterone replacement therapy and consented to participate in the study. Data from telephone interviews were transcribed for theme analysis using NVivo 9 qualitative analysis software, analyzed descriptively from a saturation grid, and used to evaluate men's P-TRT.

Daily average consumption of 2 long-acting opioids: an interrupted time series analysis.

Background: Oxycodone controlled release (CR) and oxymorphone extended release (ER) are frequently prescribed long-acting opioids, which are approved for twice-daily dosing. The US Food and Drug Administration approved a reformulated crush-resistant version of oxycodone CR in April 2010.

Objective: To compare the daily average consumption (DACON) for oxycodone CR and for oxymorphone ER before and after the introduction of the reformulated, crush-resistant version of oxycodone CR.

Comparing the cost of community pharmacy and mail-order pharmacy in a US retirement system.

Although community pharmacies have been the mainstay for drug distribution in the USA, plan members are encouraged to use mail-order pharmacies as a cost-containment strategy. Both channels differ with respect to reimbursement rates, utilization, and costs. We evaluated the differences in reimbursement rates and in ingredient costs between the two dispensing channels.

Market withdrawal of new molecular entities approved in the United States from 1980 to 2009.

Purpose: Economic factors, market dynamics, and safety issues are largely responsible for decisions to withdraw pharmaceutical products from the market. In this study, new molecular entities (NMEs) approved by the Food and Drug Administration (FDA) were examined in the USA from 1980 to 2009.

Methods: Data were obtained from the FDA, Micromedex, Medline, and Lexis-Nexis.

A Comparison of Daily Average Consumption Of Oxycodone Controlled Release (OxyContin CR) And Oxymorphone Extended Release (Opana ER) In Patients With Low Back Pain.

Objective: Our goal was to examine the daily average consumption (DACON) of oxycodone controlled-release tablets (OxyContin CR)and oxymorphone extended-release tablets (Opana ER) in patients with low back pain.

Study Design: An observational, retrospective cohort study enrolled patients with multiple prescriptions for oxycodone CR or oxymorphone ER tablets. These patients also had International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for low back pain.

Utilization, spending, and price trends for short- and long-acting Beta-agonists and inhaled corticosteroids in the medicaid program, 1991-2010.

Background: Asthma is a chronic respiratory disease that afflicts millions of people and accounts for substantial utilization of healthcare resources in most industrialized countries, including in the United States. However, the exact cost and utilization of anti-asthma medications in Medicaid in the past 2 decades have not been well studied. Considering the safety issues surrounding the long-acting beta-agonists, guideline updates, and the increase in asthma prevalence, understanding anti-asthma medication prescribing trends is important to payers and patients.

Assessing the reliability and validity of a newly developed insomnia treatment satisfaction questionnaire (ITSAT-Q).

Purpose: To produce a valid insomnia treatment satisfaction questionnaire (ITSAT-Q) to assess treatment satisfaction with pharmacotherapy for use in patients with insomnia.

Patients And Methods: Items developed for a self-administered questionnaire were analyzed using exploratory factor analysis (EFA), which produced 5 dimensions. Confirmatory factor analysis was used to verify results from EFA, and structural equation modeling was used to test the hypothesized relationship among the dimensions.

Analysis of the impact of the Uruguay Round Agreements Act on pharmaceutical patents.

The Uruguay Round Agreements Act (URAA) was enacted by the United States Congress in 1994. The URAA provided substantial modifications to the framework for U.S.

Evaluation of causes and frequency of medication errors during information technology downtime.

Purpose: The causes and frequency of medication errors occurring during information technology downtime were evaluated.

Methods: Individuals from a convenience sample of 78 hospitals who were directly responsible for supporting and maintaining clinical information systems (CISs) and automated dispensing systems (ADSs) were surveyed using an online tool between February 2007 and May 2007 to determine if medication errors were reported during periods of system downtime. The errors were classified using the National Coordinating Council for Medication Error Reporting and Prevention severity scoring index.

Psychometric development and validation of the chronic constipation treatment satisfaction questionnaire (CTSAT-Q).

Objectives: To develop and validate the constipation treatment satisfaction questionnaire (CTSAT-Q) for use in patients with chronic constipation and irritable bowel syndrome with constipation (IBS-c).

Methods: Questionnaire development included item representation from the reviewed literature, focus groups, and pretesting. Dimensions related to treatment satisfaction were identified with exploratory factor analysis, verified with confirmatory factor analysis (CFA), and tested with structural equation modeling.

Incentives for orphan drug research and development in the United States.

Background: The Orphan Drug Act (1983) established several incentives to encourage the development of orphan drugs (ODs) to treat rare diseases and conditions. This study analyzed the characteristics of OD designations, approvals, sponsors, and evaluated the effective patent and market exclusivity life of orphan new molecular entities (NMEs) approved in the US between 1983 and 2007.

Methods: Primary data sources were the FDA Orange Book, the FDA Office of Orphan Drugs Development, and the US Patent and Trademark Office.

Testing for allergic disease: parameters considered and test value.

Background: Test results for allergic disease are especially valuable to allergists and family physicians for clinical evaluation, decisions to treat, and to determine needs for referral.

Methods: This study used a repeated measures design (conjoint analysis) to examine trade offs among clinical parameters that influence the decision of family physicians to use specific IgE blood testing as a diagnostic aid for patients suspected of having allergic rhinitis. Data were extracted from a random sample of 50 family physicians in the Southeastern United States.

The relative importance of health related quality of life and prescription insurance coverage in the decision to pharmacologically manage symptoms of overactive bladder.

Purpose: Patient decisions to seek treatment for overactive bladder are influenced by the impact of the condition on health related quality of life and the presence of prescription insurance coverage. This study uses conjoint analysis to examine the relative importance of health related quality of life dimensions of the overactive bladder questionnaire and the presence of prescription insurance coverage on patient preference for treatment.

Materials And Methods: Patient preferences were elicited using a study questionnaire that included 9 hypothetical profiles containing an orthogonal array of attributes relating to coping with symptoms, symptom concern, sleep disturbances, problems with social interactions and prescription insurance coverage.

Drug utilization and cost in a Medicaid population: a simulation study of community vs. mail order pharmacy.

Background: Outpatient drugs are dispensed through both community and mail order pharmacies. There is no empirical evidence that substitution of community pharmacy with mail order reduces overall drug expenditures. The need for evaluating the potential effects on utilization and costs of the possible extension of mail order services in Medicaid provides the rationale for conducting this study.

The impact of allergic rhinitis on work productivity.

Aim: Patients with allergic rhinitis experience a multitude of symptoms that usually compromise some aspect of lifestyle. However, few data are available that specifically address the impact of allergic rhinitis on work productivity.

Methods: A questionnaire was developed and mailed to 2,065 patients enrolled in a 500,000-member managed care organisation.

Influence of patient care provider on patient health outcomes in allergic rhinitis.

Background: Diagnosing and managing the symptoms of allergic rhinitis are largely the responsibility of family physicians and allergists, but some patients choose self-management. However, few data are available to determine how the choice of care relates to measures of patient outcomes, such as the ability to perform activities, quality of life, and productivity.

Objective: To examine and compare patients' ability to perform activities, quality of life, productivity, and symptoms according to care provider: family physician, allergist, or self-management.

Preference for insulin delivery systems among current insulin users and nonusers.

Background: It is not known whether preferences for the vial and syringe (VS) or the insulin injection pen device (IIPD) differ between current insulin users and nonusers. Additional benefits in treatment might be realized if preference were considered when discussing insulin use with patients initiating or changing insulin treatment.

Objective: The objective of this study was to examine respondent preferences for the VS and the IIPD between current insulin users and nonusers.

Identification of allergic disease among users of antihistamines.

Objective: Patients exhibit a multitude of symptoms that may or may not be allergy related. In this study, we examined the consistency between results obtained by a multiallergen-specific immunoglobulin E (IgE) test and frequent use (3 months or more) of prescribed antihistamines.

Methods: A retrospective examination of 1-year prescription claims records from January 1, 2000, through December 31, 2000, for 4,643 patients enrolled in a 115,000-member managed care organization who received 1 or more prescriptions for an oral antihistamine (loratadine, fexofenadine, or cetirizine).