Raymond Jang

Risk of diabetes mellitus associated with atypical antipsychotic use among Medicaid patients with bipolar disorder: a nested case-control study.

Study Objective. To quantify the risk of diabetes mellitus associated with atypical antipsychotics compared with conventional antipsychotics in managed care Medicaid patients with bipolar disorder.

Acute Pancreatitis Associated with Different Combination Therapies in Patients Infected with Human Immunodeficiency Virus

Study Objective. To assess the risk of acute pancreatitis in patients receiving various combinations of protease inhibitors, nucleoside reverse transcriptase inhibitors (NRTIs), and nonnucleoside reverse transcriptase inhibitors (NNRTIs) for treatment of human immunodeficiency virus (HIV) infection.

IDENTIFICATION OF FACTORS LEADING TO EXCESSIVE WAITING TIMES IN AN AMBULATORY PHARMACY

A quality improvement approach incorporating the techniques of workflow analysis and time study was used in a study of excessive patient waiting time in a hospitals outpatient pharmacy. Investigators identified factors contributing to long waits by observing and timing pharmacy dispensing procedures. The results of the time study indicated that two-thirds of an average 2-hour wait occurred before filling prescriptions (49.2 minutes) and before data entry (35.8 minutes). Improvement strategies should therefore focus on improving the methods of, and the capacity for, order filling and data entry. The use of an automated dispensing system and additional data-entry terminals or a faster computer system were recommended. The approach used is a practical and accurate method for diagnosing system problems and lays a solid foundation for improvement strategies.

Medicaid Managed Care Prescription Use and Cost Savings

OBJECTIVE To evaluate the impact of Medicaid managed care (MC) enrollment on prescription use and costs. DESIGN Retrospective, cross-sectional analysis of claims submitted over a 6-month period. SETTING Ohio Medicaid. PATIENTS AND OTHER PARTICIPANTS Stratified, random selection of 2,932 MC and 1,335 fee-for-service (FFS) recipients. MAIN OUTCOME MEASURES Dependent variables were the probability of any prescription use and 6-month prescription counts and costs. Independent variables included age, plan enrollment (MC or FFS), county enrollment status (mandatory or voluntary), presence of a chronic comorbidity, and any outpatient medical visit. RESULTS After adjusting for comorbidities and outpatient medical visits, plan enrollment effects depended on age. FFS enrollees 8 to 12 and 12 to 18 years old were less likely (adjusted odds ratios 0.56 and 0.58, respectively) to receive a prescription, while enrollees over 30 years of age were 2.98 times more likely to receive a prescription. Among prescription users, level of use and costs were consistent across all ages for MC enrollees. FFS enrollees had 25% to 218% higher levels of prescription use than MC enrollees, depending on age. Prescription costs were 8% lower for FFS enrollees ages 4 to 8 but higher for all enrollees in other age groups (range, 22% to 311% higher). CONCLUSION Prescription use and costs were lower for Medicaid MC enrollees than they were for patients in traditional FFS plans. Further research is needed to examine the quality of care for both FFS and MC enrollees.

PMH37 COST CONSEQUENCE ASSOCIATED WITH DIFFERENT INITIAL MOOD STABILIZERS FOR NEWLY TREATED PATIENTS WITH BIPOLAR DISORDERS

hospitalisations and laboratory tests. This trial also reported relative safety and efficacy. Australian cost data were applied to the resource utilisation from the trial to estimate the overall treatment costs associated with each therapy. Study drug and concomitant medication prices were sourced from the Schedule of Pharmaceutical Benefits and E-MIMS, while national casemix costs were applied to hospitalisations. Rather than episodic costing, a mixture of fixed and marginal costs were used. Laboratory test prices were from the Medicare Benefits Schedule. RESULTS: The overall cost of therapy for olanzapine patients was AUS

PMH56 MENTAL HEALTH SERVICES AND DRUG UTILIZATION PATTERNS FOR STUDENTS WITH MENTAL ILLNESSES IN SCHOOL-BASED HEALTH CENTERS

9340 (US

Risk of diabetes mellitus associated with atypical antipsychotic use among patients with bipolar disorder: A retrospective, population-based, case-control study.

6457), compared with A

Impact of school-based health centers on children with asthma

9589 (US

Treatment Costs and Health Care Utilization for Patients with Bipolar Disorder in a Large Managed Care Population

6629) for lithium patients. Although the acquisition cost of olanzapine is greater than for lithium, the fewer (82 vs. 88) and shorter hospitalisations (15 vs. 19.7 days) associated with olanzapine relative to lithium therapy lead to this overall cost saving of AUS

Re-engineering a pharmacy work system and layout to facilitate patient counseling

249 (US