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Association Between Warfarin Adherence Trajectories, Hospitalization Risk, And Healthcare Utilization Among Medicare Patients With Atrial Fibrillation: A Group-Based Trajectory Modelling Approach, Mai Alhazami 2018 Virginia Commonwealth University

Association Between Warfarin Adherence Trajectories, Hospitalization Risk, And Healthcare Utilization Among Medicare Patients With Atrial Fibrillation: A Group-Based Trajectory Modelling Approach, Mai Alhazami

Theses and Dissertations

Introduction: Warfarin is the most commonly prescribed drug for stroke prevention among Atrial Fibrillation (AF) patients, especially in older adult populations, but medication nonadherence reduces its effectiveness in clinical practice. Group Based Trajectory Models (GBTM) have been used to identify distinct patterns of adherence behavior related to various medications and understand the patient characteristics associated with each trajectory. The objectives of the study were: 1) Describe trajectories of warfarin adherence among Medicare AF patients, 2) Assess impact of adherence trajectories on AF-related hospitalization, 3) Estimate the AF-related direct costs for each adherence trajectory group.

Methods: We identified elderly AF patients ...


Prescription Drug Monitoring Programs: Evolution And Evidence, Janet Weiner, Yuhua Bao, Zachary Meisel 2017 University of Pennsylvania

Prescription Drug Monitoring Programs: Evolution And Evidence, Janet Weiner, Yuhua Bao, Zachary Meisel

Issue Briefs

This Issue Brief reviews the current status and characteristics of PDMPs, their use, and evidence of their effectiveness. It summarizes best practices for PDMPs and the needs for further research and evaluation.


Reliability And Credibility Of Progress Test Criteria, Developed By Alumni, Faculty, And Mixed Alumni-Faculty Judge Panels, H. Glenn Anderson PharmD, Arthur A. Nelson PhD 2017 Marshall University

Reliability And Credibility Of Progress Test Criteria, Developed By Alumni, Faculty, And Mixed Alumni-Faculty Judge Panels, H. Glenn Anderson Pharmd, Arthur A. Nelson Phd

H. Glenn Anderson

Objective. To compare the reliability and credibility of Angoff-based, absolute criteria derived by faculty, alumni, and a combination of alumni and faculty judge panels. Methods. Independently, faculty, alumni, and mixed faculty-alumni judge panels developed pass/fail criteria for an 86-item test. Generalizability and decision studies were performed. Root mean square errors (RMSE) and 95% confidence intervals were calculated for reliability and credibility assessment. School graduate performance upon the North American Licensure Examination (NAPLEX) was the comparator for credibility assessment. Results. RMSEs were 1.06%, 1.42%, and 2.32% for the alumni, faculty, and mixed judge panels respectively. The school ...


Combining Adverse Pregnancy And Perinatal Outcomes For Women Exposed To Antiepileptic Drugs During Pregnancy, Using A Latent Trait Model, XUERONG Wen 2017 University of Rhode Island

Combining Adverse Pregnancy And Perinatal Outcomes For Women Exposed To Antiepileptic Drugs During Pregnancy, Using A Latent Trait Model, Xuerong Wen

XUERONG Wen

Background: Application of latent variable models in medical research are becoming increasingly popular. A latent trait model is developed to combine rare birth defect outcomes in an index of infant morbidity. Methods: This study employed four statewide, retrospective 10-year data sources (1999 to 2009). The study cohort consisted of all female Florida Medicaid enrollees who delivered a live singleton infant during study period. Drug exposure was defined as any exposure to Antiepileptic drugs (AEDs) during pregnancy. Mothers with no AED exposure served as the AED unexposed group for comparison. Four adverse outcomes, birth defect (BD), abnormal condition of new born ...


Ethical Imperatives Of Timely Access To Orphan Drugs: Is Possible To Reconcile Economic Incentives And Patients’ Health Needs?, Rosa Rodriguez-Monguio, T. Spargo, Enrique Seoane-Vazquez 2017 University of Massachusetts Amherst

Ethical Imperatives Of Timely Access To Orphan Drugs: Is Possible To Reconcile Economic Incentives And Patients’ Health Needs?, Rosa Rodriguez-Monguio, T. Spargo, Enrique Seoane-Vazquez

Pharmacy Faculty Articles and Research

Background

More than 6,800 rare diseases and conditions have been identified in the US, which affect 25–30 million Americans. In 1983, the US Congress enacted the Orphan Drug Act (ODA) to encourage the development and marketing of drugs to treat rare diseases and conditions. This study analyzed all orphan designations and FDA approvals since 1983 through 2015, discussed the effectiveness of incentives for the development of treatments for rare diseases, and reflected on the ethical imperatives for timely access to orphan drugs.

Methods

Study data were derived from the Food and Drug Administration (FDA) Orange Book and the ...


Burden Of Illness And Pharmacoeconomic Evaluation Of Lumacaftor/Ivacaftor In Cystic Fibrosis, Pratyusha Vadagam 2017 Duquesne University

Burden Of Illness And Pharmacoeconomic Evaluation Of Lumacaftor/Ivacaftor In Cystic Fibrosis, Pratyusha Vadagam

Electronic Theses and Dissertations

Objectives: (1) To estimate the burden of illness in cystic fibrosis (CF) using 2010-2014 Medical Expenditure Panel Survey (MEPS) data, and (2) to conduct a pharmacoeconomic evaluation of lumacaftor/ivacaftor in the treatment of CF.

Methods: The study was conducted in two parts. Part 1 involved a retrospective analysis using individuals in MEPS database with an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis code of 277.00 for a principal diagnosis of CF. Dependent variables were cumulative and out-of-pocket (OOP) expenditures and independent variables included patient demographics and clinical characteristics. Unweighted and weighted estimates of expenditure in ...


The Impact Of Objective Quality Ratings On Patient Selection Of Community Pharmacies: A Discrete Choice Experiment And Latent Class Analysis, Julie A. Patterson 2017 Virginia Commonwealth University

The Impact Of Objective Quality Ratings On Patient Selection Of Community Pharmacies: A Discrete Choice Experiment And Latent Class Analysis, Julie A. Patterson

Theses and Dissertations

Background: Pharmacy-related performance measures have gained significant attention in the transition to value-based healthcare. Pharmacy-level quality measures, including those developed by the Pharmacy Quality Alliance, are not yet publicly accessible. However, the publication of report cards for individual pharmacies has been discussed as a way to help direct patients towards high-quality pharmacies. This study aimed to measure the relative strength of patient preferences for community pharmacy attributes, including pharmacy quality. Additionally, this study aimed to identify and describe community pharmacy market segments based on patient preferences for pharmacy attributes.

Methods: This study elicited patient preferences for community pharmacy attributes using ...


E-Cigarettes And Smoking Cessation: Economic Impact On Current Smokers With Chronic Obstructive Pulmonary Disease, Anal A. Shah 2017 Virginia Commonwealth University

E-Cigarettes And Smoking Cessation: Economic Impact On Current Smokers With Chronic Obstructive Pulmonary Disease, Anal A. Shah

Theses and Dissertations

Introduction:

Awareness and usage of Electronic cigarettes (e-cigs) among smokers have increased rapidly over the past few years, majorly in quitting smoking. The main objectives for this study were: 1) To estimate the prevalence and study sociodemographic predictors for e-cigs use among individuals with Chronic Obstructive Pulmonary Disease (COPD) 2) To examine the predictors and estimate the total healthcare costs among current smokers with COPD 3) To estimate the economic impact of adopting e-cigs as a smoking cessation tool among current smokers with COPD.

Methods:

The National Health Interview Survey data from the year 2014 was utilized to estimate the ...


Pneumococcal Conjugate Vaccine 13 Coverage In Children, High-Risk Adults 19-64 Years Of Age, And Adults Over 65 Years Of Age In A Commercially Insured U.S. Population, Joseph C. Vanghelof 2017 University of Kentucky

Pneumococcal Conjugate Vaccine 13 Coverage In Children, High-Risk Adults 19-64 Years Of Age, And Adults Over 65 Years Of Age In A Commercially Insured U.S. Population, Joseph C. Vanghelof

Theses and Dissertations--Pharmacy

This thesis aimed to elucidate the demographic characteristics associated with elevated or reduced rates of pneumococcal conjugate 13 (PCV13) vaccination.

A retrospective cohort study was performed using the Truven Health MarketScan® Database. Three cohorts were created corresponding to populations for which the CDC recommends PCV13 vaccination. Cohort 1: children < 36 months of age. Cohort 2: adults 19-64 years of age with high infection risk. Cohort 3: adults > 65 years of age. Odds of having a PCV13 claim were calculated for each cohort.

For Cohort 1, 78% out of a total of 353,214 subjects had a sufficient number of PCV13 doses to meet CDC recommendations. For Cohort 2, 3.7% out of a total of 673,157 subjects ...


Comparison Of Outcomes Following A Switch From A Brand To An Authorized Vs. Independent Generic Drug, Richard Hansen, Jingjing Qian, Richard L. Berg, James G. Linneman, Enrique Seoane-Vazquez, Sarah Dutcher, Saeid Raofi, C. David Page, Peggy L. Peissig 2016 Auburn University

Comparison Of Outcomes Following A Switch From A Brand To An Authorized Vs. Independent Generic Drug, Richard Hansen, Jingjing Qian, Richard L. Berg, James G. Linneman, Enrique Seoane-Vazquez, Sarah Dutcher, Saeid Raofi, C. David Page, Peggy L. Peissig

Pharmacy Faculty Articles and Research

Authorized generics are identical in formulation to brand drugs, manufactured by the brand company but marketed as a generic. Generics, marketed by generic manufacturers, are required to demonstrate pharmaceutical and bioequivalence to the brand drug, but repetition of clinical trials is not required. This retrospective cohort study compared outcomes for generics and authorized generics, which serves as a generic vs. brand proxy that minimizes bias against generics. For the seven drugs studied between 1999-2014, 5,234 unique patients were on brand drug prior to generic entry and 4,900 (93.6%) switched to a generic. During the 12-months following the ...


Decreasing Cost Associated Medication Nonadherence, Shawn E. Raymond 2016 Pittsburg State University

Decreasing Cost Associated Medication Nonadherence, Shawn E. Raymond

Doctor of Nursing Practice

An Abstract of the Scholarly Project by

Shawn E. Raymond

Medication cost is a major contributor for patient medication nonadherence. Take in the fact that a large population lives in poverty, many cannot afford to pay the retail prices associated with purchasing their medications. By incorporating wholesale medications into a charitable health clinic, the reduced cost of medications for treatment of both acute and chronic illnesses could be passed on to those in need thereby decreasing cost associated medication nonadherence. Nurse Practitioners in the state of Kansas are not afforded the privilege to purchase, repackage and distribute or resell wholesale ...


Planning For The 2017 Specialty Drug Spend: When Costs Are Steep But Pockets Are Not Deep, Nicole M. Trask 2016 University of Massachusetts Medical School

Planning For The 2017 Specialty Drug Spend: When Costs Are Steep But Pockets Are Not Deep, Nicole M. Trask

Commonwealth Medicine Publications

Specialty drug spend increased by 15 percent to $121 billion in 2015 and is projected to rise even more. Budget-conscious payers need to implement novel management strategies that anticipate the cost of specialty medications before they’re available. A summary of efficacy data for high-impact specialty pipeline drugs expected to reach the market, including their place in therapy and budgetary impact. Also featured are strategies to mitigate costs of these cutting-edge medications and compare them to current therapy options.


The Impact Of Incorporating Of Pharmacogenomics Into The Pharmacy Curriculum On Student Interest, Natalya Vaksman, Mitchell Barnett, Leann Hakobyan, Ilya Kutcher, Maggie Louie 2016 Touro University of California

The Impact Of Incorporating Of Pharmacogenomics Into The Pharmacy Curriculum On Student Interest, Natalya Vaksman, Mitchell Barnett, Leann Hakobyan, Ilya Kutcher, Maggie Louie

Maggie Louie

Background: Pharmacogenomics content in the pharmacy curriculum has increased since AACP adopted NCHPEG guidelines in 2001. Aims: To evaluate how program level curricular changes impact pharmacy student opinions regarding pharmacogenomics, and gauge student interest in pursuing a career in pharmacogenomics. Methods: First and third year students from eight pharmacy schools in California completed a survey indicating their attitudes towards pharmacogenomics. Results: The survey concluded that the presence of a stand-alone pharmacogenomics course did not impact student perceived preparedness for a career in pharmacogenomics. Furthermore, the presence of a course did not influence student interest in pursuing a residency, fellowship, or ...


A Systematic Review Of The Cost-Effectiveness Of Chemotherapy Regimens, Chelsea R. Manion, Eric Blizzard, Emily Bruce, Hannah Chittenden, David Fisher, Lia G. Hickinbotham, Abigail Moon, Nicholas Rudy, Aleda Chen, Kristi Coe 2016 Cedarville University

A Systematic Review Of The Cost-Effectiveness Of Chemotherapy Regimens, Chelsea R. Manion, Eric Blizzard, Emily Bruce, Hannah Chittenden, David Fisher, Lia G. Hickinbotham, Abigail Moon, Nicholas Rudy, Aleda Chen, Kristi Coe

The Research and Scholarship Symposium (2013-2019)

Background: The rising cost of chemotherapy dramatically increases the burden on healthcare and presents new challenges in achieving optimal patient outcomes. New treatments, in general, are more specialized but show minor progress in regards to efficacy. Accordingly, the threat of overpaying for chemotherapy regimens has increased. There is a need for a comprehensive review to compile relevant studies in order to inform clinician decisions on the basis of cost-effectiveness and quality of life.

Objectives: The objective of this project is to assess the cost-effectiveness of anticancer medications with a special focus on the quality of life of patients undergoing chemotherapy ...


Characterization And Economic Burden Associated With Pediatric Opioid Exposures And Poisonings, Anisha M. Patel 2016 Virginia Commonwealth University

Characterization And Economic Burden Associated With Pediatric Opioid Exposures And Poisonings, Anisha M. Patel

Theses and Dissertations

Introduction

The main objectives of this study were: 1) to examine the prevalence and characteristics of opioid exposures, 2) to estimate the economic costs associated with opioid poisonings, and 3) to examine the characteristics associated with opioid poisoning-related health care resource use (HCRU) and costs in children.

Methods

Data from the National Poison Data System from January 1, 2010 to December 31, 2014 were utilized to examine the prevalence and characteristics of opioid exposures and poisonings in children <18 years. Economic costs were estimated using the 2012 Nationwide Emergency Department Sample, Kids’ Inpatient Database, Multiple Cause-of-Death file and other published sources, applying a societal perspective. Direct costs included costs associated with ED visits, hospitalizations and ambulance transports. Indirect cost included productivity costs due to caregivers’ absenteeism and premature mortality among children.

Results

There were a total of 83,418 pediatric opioid exposures and nearly half of them resulted in poisoning. The epidemiology of ...


Resource Utilization And Costs Associated With Off-Label Use Of Atypical Antipsychotics In An Adult Population, Della Varghese 2016 Virginia Commonwealth University

Resource Utilization And Costs Associated With Off-Label Use Of Atypical Antipsychotics In An Adult Population, Della Varghese

Theses and Dissertations

Introduction: Atypical Antipsychotics (AAPs) are approved by the Food and Drug Administration (FDA) for the treatment of schizophrenia and bipolar disorder. AAPs are commonly used off-label to treat depression, post-traumatic stress disorder and neuropsychiatric symptoms in dementia due to lack of alternative treatment options and treatment resistance. Concerns for off-label use arise since AAPs increase the risk of cardiovascular events and death. The objectives were 1) describe patterns of RU and costs among off-label AAPs users in a nationally representative population 2) identify prevalence of off-label use in the Medicare population 3) compare RU and costs between off-label AAPs users ...


Pharmacy Benefit Management: Are Reporting Requirements Pro- Or Anticompetitive?, Patricia M. Danzon 2015 University of Pennsylvania

Pharmacy Benefit Management: Are Reporting Requirements Pro- Or Anticompetitive?, Patricia M. Danzon

Health Care Management Papers

The market-based US health care system relies on pharmacy benefit managers (PBMs) to control pharmaceutical costs, in contrast to most other countries that regulate drug prices and access. Optimal strucuturing and regulation of PBM contracts poses significant agency challenges for private and public payers. However, recent reporting requirements for PBMs may be counterproductive and reflect the interests of competitors rather than customers.


Review Of Edison Bicudo, Pharmaceutical Research, Democracy And Conspiracy: International Clinical Trials In Local Medical Institutions, Roberto Abadie 2015 University of Nebraska-Lincoln

Review Of Edison Bicudo, Pharmaceutical Research, Democracy And Conspiracy: International Clinical Trials In Local Medical Institutions, Roberto Abadie

Sociology Department, Faculty Publications

The pharmaceutical industry is—along with the financial and weapons industries—one of the most globalized and profitable business domains. But they wouldn’t make any profits if they weren’t able to recruit research subjects to test an increasing number of drugs. This global trial economy creates its own assemblages of clinical trials, often run by hired contract research organizations (CROs), who fight among each other in a rat-race competition, promising quick and effective trials; at the same time, enterprising countries, hospitals, and doctors jump on the drug trial economy bandwagon by promising quick, endless access to a large ...


Critical Analysis Of The Confounding Of Clinical Trials, Eleanor L. Jordan 2015 James Madison University

Critical Analysis Of The Confounding Of Clinical Trials, Eleanor L. Jordan

Senior Honors Projects, 2010-2019

To provide a comprehensive overview of issues confounding clinical trials, Chapter 2 will discuss the parties involved in the research and development of medications and detail the individual responsibilities of each. However, the ambition of these individual entities often produces a conflict of interest especially when profits are involved [9]. Organizations and individuals such as insurance corporations, pharmaceutical companies (sponsors), pharmacy benefit managers, investigators (doctors/medical professionals) and most importantly patients, are all involved in carrying out clinical research and have definitive responsibilities they are required to follow for unbiased results. However, many rules are overlooked and biases go unrecorded ...


The Value Of Online Medication Rating Systems To Older Adults And Their Association With Self-Reported Outcomes, Yazed Sulaiman AlRuthia 2015 University of Tennessee Health Science Center

The Value Of Online Medication Rating Systems To Older Adults And Their Association With Self-Reported Outcomes, Yazed Sulaiman Alruthia

Theses and Dissertations (ETD)

The Internet is a powerful and very popular vehicle for distributing judgment-free health information to patients. Multiple studies have examined the role of online health information as well as physician-rating websites in health care. Studies have examined the value of online drug information for patients and the value of the online drug information for patients. However, no study has examined the usefulness or value of online medication rating websites in facilitating physician-patient communication or participant-reported outcomes. In this study, the value of online medication rating websites to older adults in facilitating communication with their physicians using a newly developed tool ...


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