Sean D. Candrilli

Prevalence and cost of nonadherence with antiepileptic drugs in an adult managed care population.

Purpose: This study assessed the extent of refill nonadherence with antiepileptic drugs (AEDs) and the potential association between AED nonadherence and health care costs in an adult‐managed care population.

Prevalence and cost of nonadherence to antiepileptic drugs in elderly patients with epilepsy

Retrospective insurance claims from the United States were analyzed to assess nonadherence to antiepileptic drugs (AEDs) and the association between AED nonadherence, seizures, and health care costs in elderly persons with epilepsy. Inclusion criteria were: age 65, epilepsy diagnosis between 1 January 2000 and 31 June 2006, 2 AED prescriptions, and insurance enrollment for 6 months pre- and 12 months post-AED initiation. Adherence was evaluated using the medication possession ratio (MPR), with MPR<0.8 defining nonadherence. Per-patient outcomes were evaluated over 12 months post-AED initiation. Of 1278 patients identified, 41% were nonadherent. Seizure, defined by epilepsy-related inpatient or emergency department admission, occurred in 12.1% of nonadherers versus 8.2% of adherers (P=0.0212). Nonadherers had higher inpatient (+

Association of antiepileptic drug nonadherence with risk of seizures in adults with epilepsy.

872, P=0.001), emergency department (+

The inpatient burden of abdominal and gynecological adhesiolysis in the US

143, P=0.0008), other outpatient ancillary (+

Type 2 Diabetes Mellitus and Renal Impairment in a Large Outpatient Electronic Medical Records Database: Rates of Diagnosis and Antihyperglycemic Medication Dose Adjustment

1741, P=0.0081), and total health care (+

Impact of Constipation on Opioid Use Patterns, Health Care Resource Utilization, and Costs in Cancer Patients on Opioid Therapy

2674, P=0.0059) costs. AED adherence among elderly patients with epilepsy is suboptimal and associated with increased seizures and health care costs.

In the absence of a central venous catheter, risk of venous thromboembolism is low in critically injured children, adolescents, and young adults: evidence from the National Trauma Data Bank.

This study evaluated the potential effect of antiepileptic drug (AED) nonadherence on the risk of subsequent seizure. Retrospective insurance claims from the United States were analyzed. Inclusion criteria were: age 21-64 years, diagnosis of epilepsy or nonfebrile convulsions, 2 AED prescriptions, and insurance enrollment for 6 months pre- and 60 days post-AED initiation. Seizure was defined as a hospital or emergency admission associated with epilepsy or nonfebrile convulsions. Observation began 7 days post-drug initiation, ending with the first of the following: seizure, insurance disenrollment, or 365 days post-drug initiation. Adherence was measured using the medication possession ratio (MPR), with MPR <0.8 defining nonadherence. Seizure risk was assessed using an extended Cox proportional hazards model. Of 18,073 subjects identified, 2467 (14%) had 1 seizure. Mean follow-up was 133 days among subjects with event and 305 days for patients without event. Seizure risk was 21% higher among nonadherers (hazard ratio=1.205, P=0.0002) than adherers.

Healthcare Utilization and Comorbidity Burden among Children and Young Adults in the United States with Systemic Lupus Erythematosus or Inflammatory Bowel Disease

BackgroundAdhesions are fibrous bands of scar tissue, often a result of surgery, that form between internal organs and tissues, joining them together abnormally. Postoperative adhesions frequently occur following abdominal surgery, and are associated with a large economic burden. This study examines the inpatient burden of adhesiolysis in the United States (i.e., number and rate of events, cost, length of stay [LOS]).MethodsHospital discharge data for patients with primary and secondary adhesiolysis were analyzed using the 2005 Healthcare Cost and Utilization Projects Nationwide Inpatient Sample. Procedures were aggregated by body system.ResultsWe identified 351,777 adhesiolysis-related hospitalizations: 23.2% for primary and 76.8% for secondary adhesiolysis. The average LOS was 7.8 days for primary adhesiolysis. We found that 967,332 days of care were attributed to adhesiolysis-related procedures, with inpatient expenditures totaling

Economic burden and comorbidities of attention-deficit/hyperactivity disorder among pediatric patients hospitalized in the United States

2.3 billion (

Health care resource utilization and costs during episodes of care for type 2 diabetes mellitus-related comorbidities☆☆

1.4 billion for primary adhesiolysis;