Chenghui Li

Trends in emergency department visits attributable to acetaminophen overdoses in the United States: 1993-2007.

With the heightened concern over acetaminophen overdose induced liver toxicity, it is important to track the overdose incidences over time. We estimated the trends in emergency department (ED) visits attributable to acetaminophen overdoses and compared the risk across sociodemographic groups and geographic regions.

Predictive Validity of the Beers and Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions (STOPP) Criteria to Detect Adverse Drug Events, Hospitalizations, and Emergency Department Visits in the United States

To compare the predictive validity of the 2003 Beers, 2012 American Geriatrics Society (AGS) Beers, and Screening Tool of Older Persons’ potentially inappropriate Prescriptions (STOPP) criteria.

Effect of the clopidogrel - Proton Pump Inhibitor drug interaction on adverse cardiovascular events in patients with Acute Coronary Syndrome

To examine the effect of the drug interaction between clopidogrel and proton pump inhibitors (PPIs) on the risk of an adverse cardiovascular event.

Medicaid Coverage and Utilization of Covered Tobacco-Cessation Treatments

BACKGROUND Although most Medicaid programs have some coverage for tobacco-cessation treatments, little is known about how well the covered treatments are utilized among Medicaid enrollees. PURPOSE To examine the impact of Arkansas Medicaid coverage of tobacco-cessation treatment on utilization of FDA-approved tobacco-cessation pharmacotherapies and counseling services by Medicaid enrollees. METHODS This study used Arkansas Medicaid administrative claims data from October 1, 2003, to June 30, 2008. Trend changes in the following monthly measures were examined: (1) total number of pharmacy claims for each covered pharmacotherapy; (2) total number of medical claims for counseling services; and (3) total number of unique enrollees who received each type of covered tobacco-cessation treatment. Average unit of defined daily dose and days with treatment stratified by tobacco-cessation products within 180 days after the first tobacco-cessation treatment were examined for intensity of treatment. Data collection was finished in 2009 and analysis was completed in 2011. RESULTS By June 30, 2008, a total of 12,673 enrollees received some tobacco-cessation treatments, and 77% of them received pharmacotherapies only. Implementation of the coverage expansion generated an initial increase in utilization of tobacco-cessation medications but quickly declined after 3 months. Utilization increased again when varenicline was added, but also decreased sharply after 6 months. Patterns of monthly claims for counseling services appeared to be inconsistent with the policy change. CONCLUSIONS Medicaid coverage alone may have limited sustained effect on increasing utilization of the covered tobacco-cessation treatments among Medicaid enrollees.

Clinical and Economic Burden of Elevated Blood Eosinophils in Patients With and Without Uncontrolled Asthma

BACKGROUND The European Respiratory Society and American Thoracic Society (ERS/ATS) published guidelines in 2014 for the evaluation and treatment of asthma. These guidelines draw attention to management of patients with asthma that remains uncontrolled despite therapy. One phenotypic characteristic of therapy-resistant asthma is eosinophil elevation. It is important to better understand the burden of care gaps in this patient subgroup in order to support improved treatment strategies in the future. OBJECTIVE To quantify the economic burden of asthma patients with and without peripheral blood eosinophil elevation. METHODS A retrospective cohort study was conducted using data from patients aged 12 years or older with a diagnosis of asthma using electronic health records of over 2 million patients between 2004-2010. Patients with a diagnosis of chronic obstructive pulmonary disease, Churg Strauss syndrome/Wegeners granulomatosis, eosinophilia, cystic/pulmonary fibrosis, allergic bronchopulmonary aspergillosis, or lung cancer in the 12-month period before the date of asthma diagnosis were excluded. Patients with asthma were followed for 12 months after their initial asthma diagnosis to identify those with controlled versus uncontrolled asthma based on ERS/ATS criteria. Patients with at least 1 peripheral blood eosinophil test result of ≥ 400 cells/µL were classified as those with elevated eosinophils. Total annual paid-claim cost was compared by eosinophil levels within the controlled and uncontrolled asthma subgroups. Costs were adjusted to 2015 U.S. dollars. Patients were stratified by control level, and generalized linear modeling regressions were used to assess the magnitude of increase in cost of the elevated eosinophil group. RESULTS A total of 2,701 patients were included in the study, of which 17% had uncontrolled asthma and 21% had elevated eosinophils. The mean total annual cost of patients with uncontrolled asthma was more than 2 times the cost of those with controlled asthma (

Variation in Anticoagulant Recommendations by the Guidelines and Decision Tools among Patients with Atrial Fibrillation

18,341 vs.

Economic burden of recurrent venous thromboembolism: Analysis from a U.S. hospital perspective

8,670, P < 0.001). Patients with uncontrolled asthma in the elevated eosinophil group had almost double the total cost (

Mental health status of varenicline and bupropion users during a quit attempt compared to current smokers, other quitters, and non-smokers ☆

28,644 vs.

Sleep deficiency among Native Hawaiian/Pacific Islander, Black, and White Americans and the association with cardiometabolic diseases: analysis of the National Health Interview Survey Data

14,188, P = 0.008) compared with those with blood eosinophil levels in a normal range. Similarly, patients classified as those with controlled asthma in the elevated eosinophil group had almost twice the average costs as those without elevated eosinophils (

Progression to Uncontrolled Severe Asthma: A Novel Risk Equation

14,754 vs.