20 results on '"Suehs, Brandon T."'
Search Results
2. Anticholinergic exposure and its association with dementia/Alzheimer's disease and mortality in older adults.
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Poonawalla, Insiya B., Xu, Yihua, Gaddy, Rainelle, James, Alex, Ruble, Matt, Burns, Salina, Dixon, Suzanne W., and Suehs, Brandon T.
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OLDER people ,COGNITION disorders ,MORTALITY ,COHORT analysis - Abstract
Background: Use of anticholinergic (ACH) medications is associated with increased risk of cognitive decline in the elderly. However, little is known about this association from a health plan perspective. Methods: This retrospective cohort study used the Humana Research Database to identify individuals with at least one ACH medication dispensed in 2015. Patients were followed until incidence of dementia/Alzheimer's disease, death, disenrollment or end of December 2019. Multivariate Cox regression models were used to assess the association between ACH exposure and study outcomes, adjusting for demographics and clinical characteristics. Results: A total of 12,209 individuals with no prior ACH use or dementia/Alzheimer's disease diagnosis were included. As ACH polypharmacy increased (i.e., from no ACH exposure, to one, two, three, and four or more ACH medications), there was a stair-step increase in the incidence rate of dementia/Alzheimer's disease (15, 30, 46, 56 and 77 per 1,000 person-years of follow-up) and in the incidence of mortality (19, 37, 80, 115 and 159 per 1,000 person-years of follow-up). After adjusting for confounders, ACH exposure to one, two, three and four or more ACH medications was associated with a 1.6 (95% CI 1.4–1.9), 2.1 (95% CI 1.7–2.8), 2.6 (95% CI 1.5–4.4), and 2.6 (95% CI 1.1–6.3) times, respectively, increased risk of a dementia/Alzheimer's disease diagnosis compared to periods of no ACH exposure. ACH exposure to one, two, three and four or more medications was associated with a 1.4 (95% CI 1.2–1.6), 2.6 (95% CI 2.1–3.3), 3.8 (95% CI 2.6–5.4), and 3.4 (95% CI 1.8–6.4) times, respectively, increased risk of mortality compared to periods of no ACH exposure. Conclusions: Reducing ACH exposure may potentially minimize long-term adverse effects in older adults. Results suggest populations which may benefit from targeted interventions to reduce ACH polypharmacy. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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3. Cardiovascular Risk in Users of Mirabegron Compared with Users of Antimuscarinic Treatments for Overactive Bladder: Findings from a Non-Interventional, Multinational, Cohort Study.
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Hoffman, Veena, Hallas, Jesper, Linder, Marie, Margulis, Andrea V., Suehs, Brandon T., Arana, Alejandro, Phiri, Kelesitse, Enger, Cheryl, Horter, Libby, Odsbu, Ingvild, Olesen, Morten, Perez-Gutthann, Susana, Xu, Yihua, Kristiansen, Nina Sahlertz, Appenteng, Kwame, de Vogel, Stefan, Seeger, John D., the mirabegron PMR-PASS study group, Seeger, John, and Bahmanyar, Shahram
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CLINICAL trials ,ADRENERGIC receptors ,PLACEBOS ,OVERACTIVE bladder ,BLADDER diseases - Abstract
Introduction: During clinical trials, mirabegron, a β3-adrenoreceptor agonist, was associated with increased vital signs vs placebo in patients with overactive bladder.Objective: The purpose of this study was to compare incidence rates of adverse cardiovascular (CV) outcomes following mirabegron or antimuscarinic use.Methods: We conducted an observational post-marketing safety study utilising real-world data. The study population was identified within five sources: Danish and Swedish National Registers, Clinical Practice Research Datalink (UK), Optum (USA) and Humana (USA). Episodes of time when patients were new users of mirabegron or antimuscarinics (October 2012-December 2018) were sourced from prescriptions and matched on propensity scores. Occurrences of major adverse cardiovascular events (MACE), acute myocardial infarction (AMI), stroke, CV mortality and all-cause mortality were identified. Outcome incidence rates and hazard ratios from Cox models were estimated.Results: Overall, 152,026 mirabegron and 152,026 antimuscarinic episodes were matched. The population consisted of 63.1% women and 72.6% were ≥ 65 years old. There were no appreciable differences in the incidence rates of MACE, AMI or stroke between users of mirabegron and antimuscarinics. Incidence rates of CV mortality (hazard ratio 0.83, 95% confidence interval 0.73-0.95) and all-cause mortality (hazard ratio 0.80, 95% confidence interval 0.76-0.84) were no higher with mirabegron vs antimuscarinics. Results restricted to episodes at high risk for CV events or stratified by age (< 65 years, ≥ 65 years) or prior overactive bladder medication use were consistent with overall findings.Conclusions: This large, multinational study found no higher risk of MACE, AMI, stroke, CV mortality or all-cause mortality among users of mirabegron relative to users of antimuscarinics. [ABSTRACT FROM AUTHOR]- Published
- 2021
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4. Novel Approach Using Administrative Claims to Evaluate Trends in Oncology Multigene Panel Testing for Patients Enrolled in Medicare Advantage Health Plans.
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Caplan, Eleanor O., Wong, William B., Ferries, Erin, Hulinsky, Rebecca, Brown, Vicky T., Bordenave, Kristine, and Suehs, Brandon T.
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ONCOLOGY ,GENETIC testing ,MEDICARE ,DRUGS ,DIAGNOSIS - Abstract
PURPOSE: To develop an approach to identify and evaluate recent use of multigene panel testing over time. METHODS: We conducted a retrospective database analysis using medical and pharmacy claims data. Medicare Advantage Prescription Drug Plan members diagnosed with select malignant solid tumors were identified. The pattern of somatic genetic testing for each patient was evaluated from January 2016 through December 2018. Tests were classified by the number of genes tested in the panel: < 50 (small or medium) and ≥ 50 (large). RESULTS: An initial feasibility study using our novel approach for identifying panel tests resulted in 2.4 and 1.2 times more large and medium panels, respectively, identified compared with using procedure codes alone. A total of 121,675 eligible patients were identified, with 131,915 unique cancer cases. Overall, 5,457 (4.5%) patients received any panel test from 2016 to 2018. We found the number of tests performed each quarter increased from 238 in Q1 of 2016 to 755 in Q4 of 2018. The highest number of cases were genitourinary cancers; however, the highest proportion of cancer-related genetic testing was among patients with respiratory cancer. Across all tumor types, the proportion of large-panel tests performed as a function of all multigene panel tests increased from 20.7% of tests in Q1 of 2016 to 46.4% of tests in Q4 of 2018. The three cancer categories with the highest count of cancer-related panel tests, respiratory cancer, GI cancer, and female reproductive cancer, had a consistently greater proportion receiving a panel test at any point postindex. CONCLUSION: Across a variety of cancers, use of somatic, large-panel cancer-related genetic testing, as a proportion of all somatic cancer-related genetic testing, increased from 2016 to 2018, although testing overall was low. [ABSTRACT FROM AUTHOR]
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- 2021
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5. Novel Approach Using Administrative Claims to Evaluate Trends in Oncology Multigene Panel Testing for Patients Enrolled in Medicare Advantage Health Plans.
- Author
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Caplan, Eleanor O., Wong, William B., Ferries, Erin, Hulinsky, Rebecca, Brown, Vicky T., Bordenave, Kristine, and Suehs, Brandon T.
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GENETIC testing ,MEDICARE ,DRUGS ,DRUG prescribing ,ONCOLOGY - Abstract
PURPOSE: To develop an approach to identify and evaluate recent use of multigene panel testing over time. METHODS: We conducted a retrospective database analysis using medical and pharmacy claims data. Medicare Advantage Prescription Drug Plan members diagnosed with select malignant solid tumors were identified. The pattern of somatic genetic testing for each patient was evaluated from January 2016 through December 2018. Tests were classified by the number of genes tested in the panel: < 50 (small or medium) and ≥ 50 (large). RESULTS: An initial feasibility study using our novel approach for identifying panel tests resulted in 2.4 and 1.2 times more large and medium panels, respectively, identified compared with using procedure codes alone. A total of 121,675 eligible patients were identified, with 131,915 unique cancer cases. Overall, 5,457 (4.5%) patients received any panel test from 2016 to 2018. We found the number of tests performed each quarter increased from 238 in Q1 of 2016 to 755 in Q4 of 2018. The highest number of cases were genitourinary cancers; however, the highest proportion of cancer-related genetic testing was among patients with respiratory cancer. Across all tumor types, the proportion of large-panel tests performed as a function of all multigene panel tests increased from 20.7% of tests in Q1 of 2016 to 46.4% of tests in Q4 of 2018. The three cancer categories with the highest count of cancer-related panel tests, respiratory cancer, GI cancer, and female reproductive cancer, had a consistently greater proportion receiving a panel test at any point postindex. CONCLUSION: Across a variety of cancers, use of somatic, large-panel cancer-related genetic testing, as a proportion of all somatic cancer-related genetic testing, increased from 2016 to 2018, although testing overall was low. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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6. Impact of Coexisting Overactive Bladder in Medicare Patients With Dementia on Clinical and Economic Outcomes.
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Caplan, Eleanor O., Abbass, Ibrahim M., Suehs, Brandon T., Ng, Daniel B., Gooch, Katherine, and van Amerongen, Derek
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Background: Patients with dementia commonly suffer from symptoms of overactive bladder (OAB); however, limited research exists on the clinical impact of coexisting OAB among patients with dementia. As such, the objective of this study was to examine the impact of OAB on clinical outcomes, health-care resource use, and associated costs among patients with dementia. Methods: We conducted a retrospective cohort analysis of patients with dementia using 3861 matched pairs of patients with and without OAB. Analyses were based on administrative claims data from January 1, 2007, to September 30, 2015, and compared clinical outcomes, health services use, and associated costs. Results: Patients with dementia and OAB were more likely than those without OAB to have least one fall (incidence rate ratio [IRR]: 1.43, 95% confidence interval [CI], 1.22-1.68, P <.001), fracture (IRR: 1.23, 95% CI, 1.05-1.44, P =.008), combined fall/fracture (IRR: 1.25, 95% CI, 1.11-1.42, P <.001), or urinary tract infection (IRR: 2.75, 95% CI, 2.55-2.96, P <.001). Patients with dementia and OAB demonstrated greater utilization of all-cause encounter types compared to similar patients without coexisting OAB (P <.01). All-cause and dementia-related total health-care costs were approximately 23% (95% CI, 0.19-0.28, P <.001) and 13% (95% CI, 0.05-0.20, P =.001), respectively, greater than similar patients without coexisting OAB. Conclusion: Coexisting OAB was associated with impacts on clinical outcomes, health-care resource utilization, and costs in patients with dementia. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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7. The Relationship Between Anticholinergic Exposure and Falls, Fractures, and Mortality in Patients with Overactive Bladder.
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Suehs, Brandon T., Caplan, Eleanor O., Hayden, Jennifer, Ng, Daniel B., and Gaddy, Rainelle R.
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MORTALITY risk factors ,COGNITIVE testing ,CONFIDENCE intervals ,DRUGS ,ACCIDENTAL falls ,BONE fractures ,LONGITUDINAL method ,SCIENTIFIC observation ,PARASYMPATHOMIMETIC agents ,HEALTH insurance reimbursement ,RETROSPECTIVE studies ,DESCRIPTIVE statistics ,OVERACTIVE bladder ,DISEASE risk factors ,OLD age ,THERAPEUTICS - Abstract
Background: Understanding risk factors associated with falls is important for optimizing care and quality of life for older patients. Objective: Our objective was to determine the relationship between anticholinergic exposure and falls, fractures, and all-cause mortality. Methods: An observational retrospective cohort study was conducted using administrative claims data from 1 January 2007 to 30 September 2015. Individuals aged 65–89 years newly diagnosed or treated for overactive bladder (OAB) were identified. Index date was the first OAB diagnosis or OAB medication prescription claim. Follow-up began on the index date and continued until death, disenrollment, or end of study period. The Anticholinergic Cognitive Burden (ACB) scale was used to define and quantify daily anticholinergic exposure and intensity. The primary study outcome was a combined endpoint of falls or fractures. All-cause mortality was a secondary endpoint. Results: There were 113,311 patients with mean age of 74.8 ± standard deviation (SD) 6.2 years included. Current anticholinergic exposure was associated with a 1.28-fold increased hazard of a fall/fracture (95% confidence interval [CI] 1.23–1.32) compared with unexposed person-time, and past exposure was associated with a 1.14-fold increased hazard of a fall/fracture (95% CI 1.12–1.17). Compared with unexposed person-time, low-, moderate-, and high-intensity anticholinergic exposure was associated with a 1.04-fold (95% CI 1.00–1.07), 1.13-fold (95% CI 1.09–1.17), and 1.31-fold (95% CI 1.26–1.36) increased hazard of falls/fractures, respectively. A similar pattern was observed for all-cause mortality. Conclusions: Anticholinergic exposure is associated with an increased risk of falls or fractures in older patients and is an important consideration when evaluating treatment options for such patients with OAB. [ABSTRACT FROM AUTHOR]
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- 2019
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8. A prospective study of elderly initiating mirabegron versus antimuscarinics: Patient reported outcomes from the Overactive Bladder Satisfaction Scales and other instruments.
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Bunniran, Suvapun, Davis, Cralen, Kristy, Rita, Ng, Daniel, Schermer, Carol R., Uribe, Claudia, and Suehs, Brandon T.
- Abstract
Aims: To understand differences in patient reported outcomes (PRO) between patients initiating mirabegron or an antimuscarinic using a validated PRO instrument, OAB‐Satisfaction (OAB‐S). Methods: This prospective observational study used real‐time prescription claims from Humana to identify Medicare patients initiating mirabegron or an antimuscarinic to participate in a series of three phone surveys over ninety days. Results: A total of 1897 mirabegron and 2444 randomly selected antimuscarinic initiators were identified; 174 mirabegron and 193 antimuscarinic initiators completed all three surveys. Among responders, mirabegron initiators were slightly older (76 vs 75 years,
P = 0.032), included more males (32% vs 23%,P = 0.044), more likely to have prior OAB treatment (21% vs 13%,P = 0.048), and had greater medication burden (number of unique medications: 10.0 vs 8.7,P = 0.014). There were no between‐group differences at any time or on any OAB‐S scale. There were significant within‐group differences at follow‐up compared to baseline for OAB‐S scales: “impact on daily living,” with improvement over the 90‐day survey period for both mirabegron (P = 0.008) and antimuscarinic (P < 0.001); “interruption of day‐to‐day life,” with improvement for both mirabegron (P < 0.001) and antimuscarinic (P < 0.001); and improvement in “OAB control” for mirabegron (P < 0.001) and antimuscarinic (P < 0.001). Conclusions: Mirabegron initiators tended to be older, had a greater number of unique medications and previously tried prescriptions to treat OAB; nonetheless, mirabegron, and antimuscarinic initiators reported similar trends in improvement in PROs over the first 90 days of treatment. Significant improvement in daily impact of OAB was observed after treatment initiation; however, no significant differences between groups were observed. [ABSTRACT FROM AUTHOR]- Published
- 2018
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9. Association of obesity with healthcare utilization and costs in a Medicare population.
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Suehs, Brandon T., Kamble, Pravin, Huang, Joanna, Hammer, Mette, Bouchard, Jonathan, Costantino, Mary E., and Renda, Andrew
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OBESITY ,MEDICARE beneficiaries - Abstract
Objectives:To examine the association of obesity with healthcare resource utilization and costs in a Medicare population. Methods:This study was a retrospective cohort study using Humana Medicare Advantage (MA) claims data. Body mass index (BMI) was assessed using ICD-9-CM status codes (V85 hierarchy) that have been validated in the data source to classify patients into BMI categories: normal (N), overweight (Ow), obese class I (ObI), obese class II (ObII), and obese class III (ObIII). Healthcare resource utilization (HRU) and costs were determined based on claims data. Descriptive statistics were used to examine baseline characteristics and HRU across BMI classes. Multivariable analysis was used to examine the association between BMI class and outcome measures. Results:Among the 172,866 patients aged ≥65 years that were identified, BMI distribution was: N, 21%; Ow 37%; ObI, 24%, ObII, 10%; and ObIII, 9%. Inpatient, emergency department and outpatient utilization increased with greater BMI level, and greater BMI level was associated with higher total healthcare, medical and pharmacy costs. Greater prevalence of several cardiometabolic conditions, total medication use, and use of specific medication classes was observed with increasing BMI class. Conclusions:Greater BMI was associated with greater HRU and costs and observed increase in prevalence of cardiometabolic conditions. These results reflect an urgent need to address the epidemic of obesity and the resulting excessive clinical and economic burden on the healthcare system. [ABSTRACT FROM AUTHOR]
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- 2017
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10. Association of obesity with healthcare utilization and costs in a Medicare population.
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Suehs, Brandon T, Kamble, Pravin, Huang, Joanna, Hammer, Mette, Bouchard, Jonathan, Costantino, Mary E, and Renda, Andrew
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COMPARATIVE studies ,RESEARCH methodology ,MEDICAL cooperation ,MEDICARE ,OBESITY ,RESEARCH ,COST analysis ,EVALUATION research ,BODY mass index ,RETROSPECTIVE studies ,PATIENTS' attitudes - Abstract
Objectives: To examine the association of obesity with healthcare resource utilization and costs in a Medicare population.Methods: This study was a retrospective cohort study using Humana Medicare Advantage (MA) claims data. Body mass index (BMI) was assessed using ICD-9-CM status codes (V85 hierarchy) that have been validated in the data source to classify patients into BMI categories: normal (N), overweight (Ow), obese class I (ObI), obese class II (ObII), and obese class III (ObIII). Healthcare resource utilization (HRU) and costs were determined based on claims data. Descriptive statistics were used to examine baseline characteristics and HRU across BMI classes. Multivariable analysis was used to examine the association between BMI class and outcome measures.Results: Among the 172,866 patients aged ≥65 years that were identified, BMI distribution was: N, 21%; Ow 37%; ObI, 24%, ObII, 10%; and ObIII, 9%. Inpatient, emergency department and outpatient utilization increased with greater BMI level, and greater BMI level was associated with higher total healthcare, medical and pharmacy costs. Greater prevalence of several cardiometabolic conditions, total medication use, and use of specific medication classes was observed with increasing BMI class.Conclusions: Greater BMI was associated with greater HRU and costs and observed increase in prevalence of cardiometabolic conditions. These results reflect an urgent need to address the epidemic of obesity and the resulting excessive clinical and economic burden on the healthcare system. [ABSTRACT FROM AUTHOR]- Published
- 2017
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11. A Historical Retrospective Analysis of the Impact of Diabetes Quality Measure Attainment on Outcomes in Medicare Advantage Members.
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Saundankar, Vishal, Ellis, Jeffrey, Moretz, Chad, Meah, Yunus, DeLuzio, Tony, Allen, Elsie, Suehs, Brandon T., and Bouchard, Jonathan
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DIABETES complications ,CHOLESTEROL ,CLINICAL medicine ,DIABETES ,DRUGS ,MEDICAL care costs ,MEDICARE ,PATIENT compliance ,QUALITY assurance ,RESEARCH funding ,STATISTICAL hypothesis testing ,MULTIPLE regression analysis ,KEY performance indicators (Management) ,RETROSPECTIVE studies ,DATA analysis software ,DESCRIPTIVE statistics ,GLYCEMIC control - Abstract
The objective of this study was to assess achievement of 4 diabetes mellitus (DM)-related quality measures (QMs) and examine the relationship between QM attainment, concurrent health care costs, and DM complications over 1 year by conducting a retrospective analysis of claims data for Medicare Advantage Prescription Drug plan members with DM. Claims and member-level quality data were used to assess QM achievement, concurrent health care costs, and presence of new or worsening DM complications during the QM year. Multivariable regression models were used to examine the relationship between QM achievement and outcome measures controlling for potentially confounding baseline characteristics. QM attainment rates ranged from 54.2% for DM Treatment measure to 83.4% for Cholesterol Screening measure. Odds of new or worsening complications were greater for members who did not meet the Blood Sugar Controlled performance goal (odds ratio [OR]: 1.12, P < 0.001), DM Treatment goal (OR: 1.40, P < 0.001), or Cholesterol Screening goal (OR: 1.32, P < 0.001). Failure to attain the DM Medication Adherence goal was associated with lower odds of new or worsening complications (OR: 0.94, P < 0.001). In the regression models, all-cause health care costs were greater for members who achieved the Blood Sugar Controlled quality goal ( P < 0.001), but lower for members who attained DM Treatment ( P < 0.001) and low-density lipoprotein Cholesterol Screening goals ( P < 0.001). There was no statistically significant relationship between attaining the DM Medication Adherence measure and all-cause costs. Achievement rates for individual QMs varied across the study population and relationships between QM attainment, health care costs, and DM complications during the QM measurement year were mixed. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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12. Effect of Potentially Inappropriate Use of Antimuscarinic Medications on Healthcare Use and Cost in Individuals with Overactive Bladder.
- Author
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Suehs, Brandon T., Davis, Cralen, Franks, Billy, Yuran, Thomas E., Ng, Daniel, Bradt, Jason, Knispel, John, Vassilakis, Maria, and Berner, Todd
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THERAPEUTICS ,CONFIDENCE intervals ,MEDICAL care use ,SCIENTIFIC observation ,RESEARCH funding ,T-test (Statistics) ,COST analysis ,RETROSPECTIVE studies ,MUSCARINIC antagonists ,OVERACTIVE bladder ,DATA analysis software ,DESCRIPTIVE statistics ,INAPPROPRIATE prescribing (Medicine) ,ODDS ratio - Abstract
Objectives To examine potentially inappropriate medication ( PIM) use in older adults initiating an antimuscarinic medication for the treatment of overactive bladder ( OAB). Design Retrospective database analysis. Setting Medical and pharmacy claims data. Participants Medicare Advantage Prescription Drug Plan members aged 65 and older newly initiated on an antimuscarinic OAB treatment were identified and assigned to PIM and non- PIM comparison groups based on 2012 American Geriatrics Society Beers Criteria and/or the presence of an anticholinergic medication interaction at the time of initiation of treatment (N = 66,275). Measurements Healthcare costs and OAB medication use. Results Of members initiated on an antimuscarinic OAB medication, 31.1% had a drug-drug or drug-disease or syndrome interaction. Dementia was the most common disease or syndrome interaction (11.3%), followed by constipation (8.6%) and delirium (2.9%). Paroxetine (2.6%), amitriptyline (2.2%), cyclobenzaprine (1.7%), and meclizine (1.6%) were the most common interacting medications. Subjects in the PIM group had greater healthcare costs over 12 months of follow-up ($12,001) than those in the non- PIM group ($9,373) after controlling for baseline characteristics ( P < .001). There was no difference between the PIM and the non- PIM groups in odds of discontinuing OAB treatment at 12 months after controlling for baseline characteristics (odds ratio = 0.98, 95% confidence interval = 0.89-1.07, P = .63). Conclusion Potentially inappropriate medication use was highly prevalent and was associated with greater total healthcare costs. Providers should carefully consider medical history and concurrent medication use when initiating antimuscarinic medication for the treatment of OAB. Development of interventions to reduce potentially inappropriate use of antimuscarinics in individuals with OAB is warranted. [ABSTRACT FROM AUTHOR]
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- 2016
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13. A Comparative Assessment of Observational Medical Outcomes Partnership and Mini-Sentinel Common Data Models and Analytics: Implications for Active Drug Safety Surveillance.
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Xu, Yihua, Zhou, Xiaofeng, Suehs, Brandon T, Hartzema, Abraham G, Kahn, Michael G, Moride, Yola, Sauer, Brian C, Liu, Qing, Moll, Keran, Pasquale, Margaret K, Nair, Vinit P, and Bate, Andrew
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COMMERCIAL product evaluation ,COMPARATIVE studies ,DATABASES ,DRUG side effects ,LONGITUDINAL method ,RESEARCH methodology ,MEDICAL cooperation ,RESEARCH ,SENTINEL health events ,EVALUATION research - Abstract
Introduction: An often key component to coordinating surveillance activities across distributed networks is the design and implementation of a common data model (CDM). The purpose of this study was to evaluate two drug safety surveillance CDMs from an ecosystem perspective to better understand how differences in CDMs and analytic tools affect usability and interpretation of results.Methods: Humana claims data from 2007 to 2012 were mapped to Observational Medical Outcomes Partnership (OMOP) and Mini-Sentinel CDMs. Data were described and compared at the patient level by source code and mapped concepts. Study cohort construction and effect estimates were also compared using two different analytical methods--one based on a new user design implementing a high-dimensional propensity score (HDPS) algorithm and the other based on univariate self-controlled case series (SCCS) design--across six established positive drug-outcome pairs to learn how differences in CDMs and analytics influence steps in the database analytic process and results.Results: Claims data for approximately 7.7 million Humana health plan members were transformed into the two CDMs. Three health outcome cohorts and two drug cohorts showed differences in cohort size and constituency between Mini-Sentinel and OMOP CDMs, which was a result of multiple factors. Overall, the implementation of the HDPS procedure on Mini-Sentinel CDM detected more known positive associations than that on OMOP CDM. The SCCS method results were comparable on both CDMs. Differences in the implementation of the HDPS procedure between the two CDMs were identified; analytic model and risk period specification had a significant impact on the performance of the HDPS procedure on OMOP CDM.Conclusions: Differences were observed between OMOP and Mini-Sentinel CDMs. The analysis of both CDMs at the data model level indicated that such conceptual differences had only a slight but not significant impact on identifying known safety associations. Our results show that differences at the ecosystem level of analyses across the CDMs can lead to strikingly different risk estimations, but this can be primarily attributed to the choices of analytic approach and their implementation in the community-developed analytic tools. The opportunities of using CDMs are clear, but our study shows the need for judicious comparison of analyses across the CDMs. Our work emphasizes the need for ongoing efforts to ensure sustainable transparent platforms to maintain and develop CDMs and associated tools for effective safety surveillance. [ABSTRACT FROM AUTHOR]- Published
- 2015
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14. A retrospective, matched cohort study of potential drug-drug interaction prevalence and opioid utilization in a diabetic peripheral neuropathy population initiated on pregabalin or duloxetine.
- Author
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Ellis, Jeffrey J., Sadosky, Alesia B., Ten Eyck, Laura L., Mudumby, Pallavi, Cappelleri, Joseph C., Ndehi, Lilian, Suehs, Brandon T., and Parsons, Bruce
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OLDER people with diabetes ,OPIOIDS ,DRUG interactions ,NERVOUS system abnormalities ,PERIPHERAL neuropathy ,DULOXETINE - Abstract
Background: Anticipating and controlling drug-drug interactions (DDIs) in older patients with painful diabetic peripheral neuropaty (pDPN) presents a significant challenge to providers. The purpose of this study was to examine the impact of newly initiated pregabalin or duloxetine treatment on Medicare Advantage Prescription Drug (MAPD) plan pDPN patients' encounters with potential drug-drug interactions, the healthcare cost and utilization consequences of those interactions, and opioid utilization. Methods: Study subjects required a pregabalin or duloxetine pharmacy claim between 07/01/2008-06/30/2012 (index event), ⩾1 inpatient or ⩾2 outpatient medical claims with pDPN diagnosis between 01/01/2008-12/31/ 2012, and ⩾12 months pre- and ⩾6 post-index enrollment. Propensity score matching was used to balance the pregabalin and duloxetine cohorts on pre-index demographics and comorbidities. Potential DDIs were defined by Micromedex 2.0 and identified by prescription claims. Six-month post-index healthcare utilization (HCU) and costs were calculated using pharmacy and medical claims. Results: No significant differences in pre-index demographics or comorbidities were found between pregabalin subjects (n = 446) and duloxetine subjects (n = 446). Potential DDI prevalence was significantly greater (p < 0.0001) among duoxetine subjects (56.7%) than among pregabalin subjects (2.9%). There were no significant differences in HCU or costs between pregablin subjects with and without a potential DDI. By contrast, duloxetine subjects with a potential DDI had higher mean all-cause costs ($13,908 vs. $9,830; p = 0.001), more subjects with ⩾1 inpatient visits (35.6% vs 25.4%; p = 0.02), and more subjects with ⩾1 emergency room visits (32.8% vs. 20.7%; p = 0.005) in comparison to duloxetine subjects without a potential DDI. There was a trend toward a difference between pregabalin and duloxetine subjects in their respective pre-versus-post differences in milligrams (mg) of morphine equivalents/ 30 days used (60.2 mg and 176.9 mg, respectively; p = 0.058). Conclusion: The significantly higher prevalence of potential DDIs and potential cost impact found in pDPN duloxetine users, relative to pregabalin users, underscore the importance of considering DDIs when selecting a treatment. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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15. Impact of a Pregabalin Step Therapy Policy Among Medicare Advantage Beneficiaries.
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Suehs, Brandon T., Louder, Anthony, Udall, Margarita, Cappelleri, Joseph C., Joshi, Ashish V., and Patel, Nick C.
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MEDICAL care use ,ANALYSIS of covariance ,LONGITUDINAL method ,MEDICAL care costs ,MEDICARE ,MEDICAL prescriptions ,SCIENTIFIC observation ,HEALTH outcome assessment ,REGRESSION analysis ,RESEARCH funding ,STATISTICS ,T-test (Statistics) ,LOGISTIC regression analysis ,TREATMENT effectiveness ,HUMAN services programs ,RETROSPECTIVE studies ,DATA analysis software ,PREGABALIN ,DESCRIPTIVE statistics ,ODDS ratio ,ECONOMICS - Abstract
Background Managed healthcare organizations often utilize formulary management strategies such as prior authorization and step therapy to guide appropriate medication use and to control medication expenditures. The objective of this study was to examine clinical and economic outcomes associated with implementation of a pregabalin step therapy ( ST) policy among Medicare Advantage Prescription Drug ( MAPD) members. Methods Pharmacy and medical claims data from Humana (restricted cohort; ST policy implemented 01/01/2009) and Thomson Reuters MarketScan
® (unrestricted cohort) were analyzed for MAPD members aged 65 to 89 years receiving treatment for painful diabetic peripheral neuropathy ( pDPN), postherpetic neuralgia (PHN) or fibromyalgia (FM). Difference-in-differences (DID) was used to examine year-over-year changes in disease-related and all-cause utilization and costs. Regression analyses examined medication utilization and healthcare expenditures after controlling for between-group compositional differences. Results We identified 13,911 members in the restricted cohort and matched to members from unrestricted health plans. FM (51.0%) and pDPN (41.8%) were the most common diagnoses. Members in the unrestricted cohort were older and had a greater level of comorbidity than members in the restricted cohort. The restricted cohort demonstrated greater year-over-year decrease in pregabalin utilization and increase in year-over-year gabapentin utilization compared with the unrestricted cohort. ST restriction was associated with an increase in disease-related pharmacy costs and a decrease in total medical costs for the restricted cohort compared with the unrestricted cohort. There was no difference between cohorts in total healthcare cost. Conclusion After controlling for differences in age and comorbidity burden between the groups, implementation of a pregabalin ST restriction was associated with increased disease-related pharmacy costs and decreased total medical costs; however, there was no net difference in total healthcare cost or total pharmacy cost. [ABSTRACT FROM AUTHOR]- Published
- 2014
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16. Household Members of Persons with Alzheimer's Disease: Health Conditions, Healthcare Resource Use, and Healthcare Costs.
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Suehs, Brandon T., Shah, Sonali N., Davis, Cralen D., Alvir, Jose, Faison, Warachal E., Patel, Nick C., Amerongen, Derek, and Bobula, Joel
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ALZHEIMER'S disease ,MEDICAL care costs ,HEALTH status indicators ,LONGITUDINAL method ,MEDICAL care use ,SCIENTIFIC observation ,RESEARCH funding ,BURDEN of care ,RETROSPECTIVE studies ,DATA analysis software ,FAMILY attitudes ,DESCRIPTIVE statistics ,ECONOMICS ,PSYCHOLOGY - Abstract
Objectives To compare medical condition burden, healthcare resource use, and healthcare costs of household members ( HHMs) of individuals diagnosed with Alzheimer's disease ( AD) with those of HHMs of matched individuals without AD. Design Retrospective cohort study based on administrative claims data collected between January 1, 2007, and December 31, 2011. Setting Medicare Advantage Prescription Drug ( MAPD) plan. Participants MAPD plan members with a diagnosis of AD ( International Classification of Disease Ninth Revision, Clinical Modification, code 331.0) were selected and linked to a HHM to form patient- HHM dyads. AD dyads were matched to non- AD dyads. Measurements Health-related endpoints, including medical condition burden, healthcare resource use, and direct healthcare costs, were measured during 36 months of continuous health plan enrollment. Results Individuals with AD (n = 1,861) were linked to HHMs (n = 1,861), and these AD dyads were matched to 1,861 non-AD patient-HHM dyads. AD HHMs had greater medical condition burden scores than non- AD HHMs, with mood disorders, anxiety disorders, insomnia, substance abuse or dependence, cardiovascular disease, and rheumatoid arthritis being more prevalent in AD HHMs. Emergency department and outpatient service use were more common in AD HHMs than in non- AD HHMs, and AD HHMs had greater healthcare costs. Conclusion HHMs of individuals diagnosed with AD demonstrated greater medical condition burden, healthcare resource use, and direct healthcare costs than non- AD HHMs. These findings demonstrate the significant clinical and financial impact of AD on HHMs of individuals with AD. [ABSTRACT FROM AUTHOR]
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- 2014
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17. The Clinical and Economic Burden of Newly Diagnosed Alzheimer’s Disease in a Medicare Advantage Population.
- Author
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Suehs, Brandon T., Davis, Cralen D., Alvir, Jose, van Amerongen, Derek, PharmD, Nick C. Patel, Joshi, Ashish V., Faison, Warachal E., and Shah, Sonali N.
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- 2013
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18. The Clinical and Economic Burden of Newly Diagnosed Alzheimer’s Disease in a Medicare Advantage Population.
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Suehs, Brandon T., Davis, Cralen D., Alvir, Jose, van Amerongen, Derek, PharmD, Nick C. Patel, Joshi, Ashish V., Faison, Warachal E., and Shah, Sonali N.
- Abstract
Background/Rationale: Alzheimer's disease (AD) represents a serious public health issue affecting approximately 5.4 million individuals in the United States and is projected to affect up to 16 million by 2050. This study examined health care resource utilization (HCRU), costs, and comorbidity burden immediately preceding new diagnosis of AD and 2 years after diagnosis. Methods: This study utilized a claims-based, retrospective cohort design. Medicare Advantage members newly diagnosed with AD (n = 3374) were compared to matched non-AD controls (n = 6748). All patients with AD were required to have 12 months of continuous enrollment prior to AD diagnosis (International Classification of Diseases, Clinical Modification [ICD-9] 331.0), during which time no diagnosis of AD, a related dementia, or an AD medication was observed. Non-AD controls demonstrated no diagnosis of AD, a related dementia, or a prescription claim for an AD medication treatment during their health plan enrollment. Medical and pharmacy claims data were used to measure HCRU, costs, and comorbidity burden over a period of 36 months (12 months pre-diagnosis and 24 months post-diagnosis). Results: The HCRU and costs were greater for AD members during the year prior to diagnosis and during postdiagnosis years 1 and 2 compared to controls. The AD members also displayed greater comorbidity than their non-AD counterparts during postdiagnosis years 1 and 2, as measured by 2 different comorbidity indices. Conclusions: Members newly diagnosed with AD demonstrated greater HCRU, health care costs, and comorbidity burden compared to matched non-AD controls. [ABSTRACT FROM PUBLISHER]
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- 2013
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19. Effects of olanzapine and risperidone on metabolic factors in children and adolescents: a retrospective evaluation.
- Author
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Khan RA, Mican LM, Suehs BT, Khan, Rais A, Mican, Lisa M, and Suehs, Brandon T
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- 2009
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20. Erratum to: A Comparative Assessment of Observational Medical Outcomes Partnership and Mini-Sentinel Common Data Models and Analytics: Implications for Active Drug Safety Surveillance.
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Xu, Yihua, Zhou, Xiaofeng, Suehs, Brandon T, Hartzema, Abraham G, Kahn, Michael G, Moride, Yola, Sauer, Brian C, Liu, Qing, Moll, Keran, Pasquale, Margaret K, Nair, Vinit P, and Bate, Andrew
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- 2015
- Full Text
- View/download PDF
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