Hind T. Hatoum

Zoledronic acid and skeletal complications in patients with solid tumors and bone metastases: analysis of a national medical claims database.

Bone is among the most common sites of metastasis in patients with advanced cancer, and the development of bone metastases places patients at increased risk for skeletal complications.

An Eleven-Year Review of the Pharmacy Literature: Documentation of the Value and Acceptance of Clinical Pharmacy

The primary objectives of the article were accomplished by providing both a bibliography of articles dealing with clinical pharmacy services in acute-care facilities and summaries of those constituting original research reports on clinical pharmacy services. However, in the process, we made the following interesting observations. We found that articles reporting impacts on cost, quality, and attitude numbered 48, 58, and 24, respectively. Most articles relating to drug therapy monitoring, with minor exceptions, dealt with either the quality or cost-savings impact or a combination of both. Also, articles concerning drug therapy monitoring comprised almost half of all those summarized (40 articles). Articles detailing drug information and education (category 2) numbered 28 and dealt mainly with attitudes or quality impacts with minor reference to cost-savings. It was also interesting, albeit expected, to observe that the bulk of attitudinal studies fell in category 2. We found category 5, controlling medication administration, had 13 articles, primarily concerned with cost and or quality. Category 4, reporting and detection of adverse drug reactions, contained a total of eight articles mainly studying the impact on quality. The other categories contained very few, if any, articles. From these results, it is evident that the profession has made significant strides in building a strong scientific data base to support the value of its clinical services. However, there is ample room for additional original research reports. Although it can be argued that alone many of the studies could not justify clinical pharmacy as cost-effective, organized as one reference they provide an invaluable resource. Although it might be unreasonable to expect each pharmacy department to be able to cost-justify its existence, this work presents the background data needed to begin or develop such efforts.

Predicting time to nursing home placement based on activities of daily living scores – a modelling analysis using data on Alzheimer's disease patients receiving rivastigmine or donepezil

Abstract Objective: To quantify the impact of activities of daily living (ADL) scores on the risk of nursing home placement (NHP) in Alzheimers disease (AD) patients. Setting: Models predicting NHP for AD patients have depended on cognitive deterioration as the primary measure. However, there is increased recognition that both patient functioning and cognition are predictive of disease progression. Methods: Using the database from a prospective, randomised, double-blind trial of rivastigmine and donepezil, two treatments indicated for AD, Cox regression models were constructed to predict the risk of NHP using age, gender, ADL and MMSE (Mini-Mental State Examination) scores as independent variables. Participants: Patients aged 50–85 years, with MMSE scores of 10–20, and a diagnosis of dementia of the Alzheimer type. Results: Cox regression analyses indicated that being female, older age, lower ADL score at baseline, and deterioration in ADL all significantly increased the risk of NHP. Over 2 years, risk of NHP increased by 3% for each 1-point deterioration in ADL score independent of cognition. Conclusion: Data analyses from this long-term clinical trial established that daily functioning is an important predictor of time to NHP. Further research may be required to confirm whether this finding translates to the real world.

The attributable clinical and economic burden of skin and skin structure infections in hospitalized patients: a matched cohort study

We estimated the incremental clinical and economic burden of skin and skin structure infections (SSSI) in hospitalized patients using a matched cohort study design. Cases with SSSI as secondary diagnosis were matched with up to 4 randomly selected non-SSSI controls by age, gender, admission date, and ICD-9 code of principal diagnosis. Among the 1 472 965 hospitalizations episodes, 23 026 had SSSI as their secondary diagnosis. Matching was successful in 22 551 (98%) cases. Compared with controls (n = 87 811), the cases had an average mean unadjusted length of hospital stay (LOS) of 5 days longer and excess hospital charges over

Safety and efficacy of retreatment with a bioengineered hyaluronate for painful osteoarthritis of the knee: results of the open-label Extension Study of the FLEXX Trial

21 000 and higher mortality rate (5.4% versus 3.5%). Adjusted estimates from regression models revealed that SSSI incurred on average 3.81 additional days and

Outcomes and management costs in patients hospitalized for skin and skin-structure infections

14 794 excess hospitalization charges. Risk of mortality was significantly higher in the cases (odds ratio, 1.32). P value was <0.0001 for all unadjusted and adjusted outcomes. Compared with their matched controls, patients with SSSI had significantly longer LOS, higher mortality, and higher hospital charges.

Cost-effectiveness analysis of intra-articular injections of a high molecular weight bioengineered hyaluronic acid for the treatment of osteoarthritis knee pain

OBJECTIVE To evaluate the safety of repeated intra-articular (IA) injections of Euflexxa® (1% sodium hyaluronate; IA--BioHA) for painful knee osteoarthritis (OA). DESIGN Participants who completed the randomized, double-blind, 26-week FLEXX Trial comparing IA-BioHA to IA saline (IA-SA) for knee OA(1) received three weekly IA-BioHA injections in a 26-week Extension Study. Adverse events (AEs) were recorded and the effect of treatment on knee pain was measured immediately following a 50-foot walk test using a 100 mm visual analog scale (VAS). Responder rate, Medical Outcomes Study Short Form 36 scores, Patients Global Assessment, and intake of rescue medication were also evaluated. RESULTS The Extension Study included 433 subjects, 219 who received IA-BioHA and 214 who received IA-SA during the FLEXX Trial. Safety results from the Extension Study indicated that 43.4% (188/433) of subjects had AEs, of which 4.8% (21/433) were deemed treatment-related AEs. Two AEs in the Extension Study led to discontinuation, and no joint effusion was reported. Patients who continued with IA-BioHA in the Extension Study maintained their improvement from baseline, with an average reduction in pain in the VAS score of -3.5 mm. Patients initially treated with IA-SA in the FLEXX Trial also had a reduction in VAS score of -9.0 mm. Secondary efficacy variables also improved during the Extension Study. CONCLUSIONS Repeat injections of IA-BioHA were effective, safe, well tolerated, and not associated with an increase in AEs, such as synovial effusions. Additional symptom improvements were noted for subjects who received either IA-BioHA or IA-SA in the FLEXX Trial. CLINICAL TRIAL REGISTRATION NUMBER NCT00379236.

Impact of 5-HT3 receptor antagonists on chemotherapy-induced nausea and vomiting: a retrospective cohort study.

BACKGROUND This study was conducted to determine outcomes and costs of treating complicated skin and skin-structure infections (cSSSIs) due to gram-positive only, gram-negative only, or mixed pathogens (gram-positive and gram-negative), including those with methicillin-resistant Staphylococcus aureus (MRSA) or Pseudomonas aeruginosa. METHODS Data on length of stay (LOS), mortality, and charges for cSSSIs were compiled from claims in the multihospital Solucient database from 2002 to 2006. RESULTS Among the 5156 cases with pathogens identified, 59.7% were gram-positive, 21.5% were gram-negative, and 18.8% were mixed. Patients with mixed pathogens incurred significantly higher LOS (17.2 days), mortality (10.2%), and charges (

Zoledronic acid therapy impacts risk and frequency of skeletal complications and follow-up duration in prostate cancer patients with bone metastasis

80,093) than those with cSSSIs due to gram-negative pathogens (10.1 days, 6.5%, and

Treatment persistence with monthly zoledronic acid is associated with lower risk and frequency of skeletal complications in patients with breast cancer and bone metastasis.

41,634, respectively) or to gram-positive pathogens (9.5 days, 4.8%, and