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1. Real-World Adherence and Discontinuation of Glucagon-Like Peptide-1 Receptor Agonists Therapy in Type 2 Diabetes Mellitus Patients in the United States

Author

Weiss T, Carr RD, Pal S, Yang L, Sawhney B, Boggs R, Rajpathak S, and Iglay K

Subjects
glp-1 ra, adherence, discontinuation, united states, Medicine (General), R5-920
Abstract

Tracey Weiss,1 Richard D Carr,2,3 Sampriti Pal,4 Lingfeng Yang,1 Baanie Sawhney,4 Robert Boggs,1 Swapnil Rajpathak,1 Kristy Iglay1 1Center for Observational and Real-World Evidence, Merck & Co., Inc, Kenilworth, NJ, 07033, USA; 2Global Medical Affairs, Merck Sharp & Dohme Limited (MSD), Hoddesdon, EN11 9BU, UK; 3Hatter Cardiovascular Institute, University College London, London, WC1E 6HX, UK; 4Real-World Evidence, Complete HEOR Solutions (CHEORS), Pennsylvania, PA, 19454, USACorrespondence: Tracey Weiss Tel +1 (908) 873-9697Email tracey.weiss@merck.comAim: To assess adherence and discontinuation of injectable glucagon-like peptide-1 receptor agonists (GLP-1 RA) at 12 and 24 months among adult type 2 diabetes mellitus (T2DM) patients in the United States initiating GLP-1 RA using the administrative claims-based database, Optum Clinformatics® Data Mart 7.1.Methods: A retrospective study was conducted from 01/2009 to 12/2017. Patients were required to be continuously enrolled for 12 months prior to their first GLP-1 RA prescription. Proportion of days covered (PDC) from prescription claims ≥ 0.80 defined adherence. Discontinuation was defined as a ≥ 90-day gap from the last date of GLP-1 RA supply to the first date of subsequent prescription claim.Results: A total of 4791 T2DM patients had ≥ 1 and 3907 had ≥ 2 GLP-1 RA prescription claims. 50.9% and 47.4% of patients were adherent at 12 and 24 months, respectively. Adherence was significantly higher among patients on weekly vs daily doses (p< 0.001). Median time to discontinuation was 13 months. The discontinuation rate was 47.7% and 70.1% at 12 and 24 months, respectively, with differences at 24 months for age and dosing frequency (p< 0.001 for both).Conclusion: Over half of T2DM patients initiating GLP-1 RA were non-adherent and the majority (70.1%) discontinued therapy by 24 months. Reasons for non-adherence and discontinuation merit further research.Keywords: GLP-1 RA, adherence, discontinuation, United States

Published
2020

11. Dose distribution and up-titration patterns of metformin monotherapy in patients with type 2 diabetes.

Author

Iglay, K, Sawhney, B, Fu, AZ, Fernandes, G, Crutchlow, MF, Rajpathak, S, Khunti, K, Iglay, K, Sawhney, B, Fu, AZ, Fernandes, G, Crutchlow, MF, Rajpathak, S, and Khunti, K

Abstract

AIMS: To assess the dose distribution among users of metformin monotherapy as well as the patterns of up-titration following initiation of therapy in people with type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: This was a retrospective cohort study of adults with T2DM in the United Kingdom (UK). Metformin dose distribution was assessed at 0, 6 and 12 months in people initiating metformin monotherapy (new users) and cross-sectionally in people with ongoing metformin monotherapy (prevalent users). Patterns and predictors of up-titration were also analysed in new users. Dose distributions and treatment patterns were assessed descriptively; predictors of up-titration were determined using multivariable logistic regressions. RESULTS: Totals of 6174 new users and 8733 prevalent users were included. New users initiated metformin at >0 mg to ≤500 mg (25%), >500 mg to ≤1000 mg (47%), >1000 mg to ≤1500 mg (17%) or >1500 mg to ≤2000 mg (12%) daily. This distribution did not vary over time. Prevalent users of metformin received doses of >0 mg to ≤500 mg (14%), >500 mg to ≤1000 mg (40%), >1000 mg to ≤1500 mg (15%), >1500 mg to ≤2000 mg (29%) or >2000 mg (1%) daily. Among new users of metformin, 6.7% and 10.8% had been up-titrated at 6 and 12 months, respectively, despite the majority having glycated haemoglobin >53 mmol/mol. Predictors of up-titration included younger age and higher HbA1c. CONCLUSIONS: A majority of T2DM patients taking metformin received a dose ≤1000 mg/day. Up-titration of metformin is infrequent in the first year postinitiation.

Published
2020

14. Irish neurological association: Proceedings of 28th annual meeting, beaumont hospital, Dublin, 15th-16th may, 1992

Author

Sakas, D. E., O’Connor, G., Singh, J., Dias, L., Eljamel, M. S., Mathew, B., Clements, B., Irvine, A., Gray, W. J., Byrnes, D. P., Bailey, I. C., Pathirana, N., Refsum, S., Bell, K. E., McKinstry, C. S., Callaghan, N., Crowley, M., Goggin, T., MacDermott, N., O’Driscoll, K. J., Neary, D., Pearson, N. A., Snowden, J. S., Brown, S., Vaughan, M., McMackin D., Phillips J., Burke T., Murphy S., Staunton H., Cristea, R. L., Hourihane, M., Farrell, M. A., Morrison, P. J., Nevin, N. C., Collins, A. D., Gibson, M., Behan, W. M. H., Simpson, K. S., Cavanagh, H. M., Gow, J. W., Gillespie, J. S., Behan, P. O., Sklar, R. M., Brown, R. H., Gillian, A. M., O’Mahony, D., Breen, K. C., Hutchinson, J., Burke, T., Hutchinson, M., Droogan, A. G., Crockard, A. D., Hawkins, S. A., McNeill, T. A., Gutowski, N. J., Chirico, S., Pinkham, J. M., Smith, C., Akanu, D., Kaur, H., Strange, R. C., Halliwell, B., Murphy, R. P., Rogers, L., Weick, J., Estes, M., Elrington, G. M., Morris, C. S., Reffin, J. P., Tregear, S. J., Ripley, L. J., Rees, J. E., Irvine, A. D., O’Brien, D. P., Dias, P. S., Herity, N., Hawkins, S., McMenamin, J. B., Mirakhur, M., Allen, I. V., Bresnihan, B., Fitzsimmons, M., Sawhney, B., Patterson, V., Bailey, I. C., Byrnes, D., Watt, M., Lee, Kui-Chung, Redmond, J. M. T., McKenna, M. J., Feingold, M., Ahmad, B. K., Watt, M., Cunningham, R. T., Winder, J., Lawson, J. A., Johnston, C. F., Buchanan, K. D., Dean, G., Elian, M., Gray, W. P., Ryder, D. Q., Buckley, T. F., Breathnach, K., Ooi, A., Farrell, M., Doherty, C., Hayes, F. J., Redmond, J. J. T., McKenna, M. M., Redmond, J. M. T., Farrell, M., Watt, M., Gibson, J. M., Patterson, V. H., Redmond, J. M. T., McKenna, M. J., Feingold, M., Ahmad, B. K., Moran, M., Burke, M., King, M. D., Moran, M., Burke, M., Hardiman, O., Reid, V., Dowd, J. O., Murphy, R., Rashad, E., Toland, J., Phillips, J. P., Staunton, H., Shu-Ming, Peng, Coughlin, A., Phillips, J. P., McCoy, D. M., Qureshi, A., Black, M. A., Grace, P. A., Bouchier-Hayes, D., and Dwyer, R.

Published
1993
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22. Irish Society of Gastroenterology — Winter Meeting Held at Freeman Auditorium, Mater Misericordiae Hospital, Dublin on Friday, 20th and Saturday, 21st November, 1987

Author

Brown, J. S., Humphreys, W. W., Parks, T. G., Dolan, C., O’Farrelly, C., Weiser, H., Whelan, A., Weir, D. G., Feighery, C., Mackle, E. J., Parks, T. G., Pender, D., Moghissi, K., Geraghty, J. G., Anderson, W. J., Carter, D. C., Cuddihy, A., Jenkins, D., Whelton, M. J., Gilligan, D., Cafferkey, M., Keane, C., O’Morain, C., MacMathuna, P., O’Connor, M. K., O’Connor, M. P., Freyne, P., Keeling, P. W. N., Deasy, J. M., Lavelle, J. P., Clery, A. P., Mackle, E. J., Sawhney, B. B., Mills, J. O. M., Parks, T. G., O’Connor, H. J., Ellis, W. R., Manning, A. P., Lintott, D. L., McMahon, M. J., Axon, A. T. B., Stuart, R., Byrne, P., Keeling, P., Connolly, J., Keane, R. M., Hennessy, T. P. J., Courtney, M. G., McDonald, G. S. A., Hourihane, D. O’B., Weir, D. G., McGibney, Carol, Darzi, A., Monson, J. R. T., Morrison, P., Tanner, W. A., Keane, F. B., Tobin, A., Gilligan, D., Hutchinson, L., Casey, E., McKenna, D., Keane, C. T., Sweeney, E. A., O’Morain, C. A., MacMathuna, P., Foley, B., O’Reilly, T., Chua, A., Feely, J., Keeling, P. W. N., Kelly, C. P., Dolan, C., Feighery, C., Weir, D. G., Darzi, A., Monson, J. R. T., Kay, E., Hurley, C. D., Tanner, W. A., Keane, F. B. V., Deasy, J. M., Carr, J., Clery, A. P., O’Donoghue, D. P., Duffy, M. J., Afdhal, N. H., Creagh, T., Broe, P., Bouchier-Hayes, D., Moran, B. J., Busch, I., Singleton, J. McL, Johnston, P., O’Brien, M., Dervan, P., Crowe, J., Lennon, J., Carney, D. N., Bourke, S., Murphy, B., Maher, K., Stafford, F., O’Morain, C., Daly, C. A., Gorey, T. F., Lavelle, J., Coakley, J. B., Bouchier-Hayes, D., Peng, S. Y., Parks, T. G., Maxwell, W. J., Keating, J., Hogan, F. P., McDonald, G. S. A., Keeling, P. W. N., Coyle, D., Gorey, T. F., Leahy, A. L., Fitzpatrick, P., Bouchier-Hayes, D., O’Donoghue, D. P., Duffy, M. J., Afdhal, N. H., Waldron, D. J., Gill, R. C., Bowes, K. L., Gallagher, R. B., Cervi, P., Dolan, C., Kelly, J., Weir, D. G., Feighery, C., Lavelle, E. M., Stevens, F. M., Duffy, B. S., Coghlan, J. G., Gilligan, D., Humphries, H., McKenna, D., Sweeney, E., Keane, C., O’Morain, C., Murray, D., O’Mahony, S., Buchanan, K., and Whelton, M.

Published
1988
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24. Irish neurological association: Meeting, Belfast, May 20th/21st, 1983

Author

McCormick, Derek, Wallace, Ian, Thompson, A., Hutchinson, M., Hawkins, S. A., Connolly, J. H., Lyttle, J. A., Montgomery, E. A., McClelland, R. J., Houston, G., Fenton, G. W., Millar, Harold, Martin, E. A., Galway, J. E., Sawhney, B. B., Forsythe, Ian, Sills, Mike, Callaghan, N., Kenny, Rose Anne, O’Neill, B., Crowley, M., Goggin, T., McDonald, Kenneth, Bresnihan, Barry, Behan, Wilhemina M. H., Behan, Peter O., O’Laoire, Sean, Hutchinson, Ros, Nevin, Norman C., Finucane, Paul, Murphy, Sean F., Morrow, James, McDowell, Helen, Ritchie, Catherine, Patterson, Victor, Brown, D. A., McClure, B. G., Lawless, V., and O’Donnell, L.

Published
1984
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25. Irish endocrine society: Proceedings of meeting held on 14th and 15th October, 1983

Author

Drury, R. R., Cregan, D., Keenan, P., Murphy, M., Drury, M. I., Reeves, W. G., Kennedy, L., Manolas, K., Wilson, K., Montgomery, D. A. D., Joplin, G. J., Kennedy, T. L., Welbourn, R. B., Byrne, M., Skrabanek, P., Tempany, E., Powell, D., Beacom, R., Middleton, D., Sawhney, B., Noonan, Noirin, Tomkin, Gerald H., Hutchinson, Michael, Kingston, S. M., Collins, W. C. J., Bell, P. M., Hayes, J. R., Hadden, D. R., O’hanrahan, T. J., Dervan, P., Heffernan, S. J., McMullan, N. M., Smyth, P. P. A., Curtis, J. A., Baily, J. D., Bain, J., Sequeira, S., McKenna, T. J., Sullivan, Patrick A., DeQuattro, Vincent, Foti, Andrew, Atkinson, A. B., Carson, D. J., Kennedy, H., Woods, A. L., Sheridan, B., O’Hare, J. A., Ferriss, J. B., Brady, D., Twomey, B. M., O’Sullivan, D. J., Lyons, T. J., Postlethwaite, W., Svheridan, B., Woodhead, J. S., Sinnamon, D. G., Traub, A. I., Thompson, W., Neylan, D., O’Donovan, D. K., McMullan, N., Blair, A. L. T., Wilson, E. A., Merrett, J. D., Weaver, J. A., Osterberg, P. H., Magee, B., and Hadden

Published
1984
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29. New weakness in a critically ill patient

Author

Craig, J., Mirakhur, M., Sawhney, B., and Patterson, V.

Subjects
Adult, Hospitalization, Muscle Weakness, Self-Assessment Questions, Critical Illness, Humans, Female, General Medicine, Prognosis, Letters to the Editor, Ventilator Weaning, Asthma
Published
1999

31. Electronic states of molecules. II.

Author

Hanley, M. J, Sahni, R. C, and Sawhney, B. C

Subjects
Physics, Atomic, Molecular, And Nuclear
Abstract

Self consistent field molecular orbital method in LCAO /linear combination of atomic orbitals/ approximation applied to LiH ground state for potential energy curve

Published
1969

43. Irish neurological association

Author

Sakas, D. E., primary, O’Connor, G., additional, Singh, J., additional, Dias, L., additional, Eljamel, M. S., additional, Mathew, B., additional, Clements, B., additional, Irvine, A., additional, Gray, W. J., additional, Byrnes, D. P., additional, Bailey, I. C., additional, Pathirana, N., additional, Refsum, S., additional, Bell, K. E., additional, McKinstry, C. S., additional, Callaghan, N., additional, Crowley, M., additional, Goggin, T., additional, MacDermott, N., additional, O’Driscoll, K. J., additional, Neary, D., additional, Pearson, N. A., additional, Snowden, J. S., additional, Brown, S., additional, Vaughan, M., additional, McMackin, D., additional, Phillips, J., additional, Burke, T., additional, Murphy, S., additional, Staunton, H., additional, Cristea, R. L., additional, Hourihane, M., additional, Farrell, M. A., additional, Morrison, P. J., additional, Nevin, N. C., additional, Collins, A. D., additional, Gibson, M., additional, Behan, W. M. H., additional, Simpson, K. S., additional, Cavanagh, H. M., additional, Gow, J. W., additional, Gillespie, J. S., additional, Behan, P. O., additional, Sklar, R. M., additional, Brown, R. H., additional, Gillian, A. M., additional, O’Mahony, D., additional, Breen, K. C., additional, Hutchinson, J., additional, Hutchinson, M., additional, Droogan, A. G., additional, Crockard, A. D., additional, Hawkins, S. A., additional, McNeill, T. A., additional, Gutowski, N. J., additional, Chirico, S., additional, Pinkham, J. M., additional, Smith, C., additional, Akanu, D., additional, Kaur, H., additional, Strange, R. C., additional, Halliwell, B., additional, Murphy, R. P., additional, Rogers, L., additional, Weick, J., additional, Estes, M., additional, Elrington, G. M., additional, Morris, C. S., additional, Reffin, J. P., additional, Tregear, S. J., additional, Ripley, L. J., additional, Rees, J. E., additional, Irvine, A. D., additional, O’Brien, D. P., additional, Dias, P. S., additional, Herity, N., additional, Hawkins, S., additional, McMenamin, J. B., additional, Mirakhur, M., additional, Allen, I. V., additional, Bresnihan, B., additional, Fitzsimmons, M., additional, Sawhney, B., additional, Patterson, V., additional, Byrnes, D., additional, Watt, M., additional, Lee, Kui-Chung, additional, Redmond, J. M. T., additional, McKenna, M. J., additional, Feingold, M., additional, Ahmad, B. K., additional, Cunningham, R. T., additional, Winder, J., additional, Lawson, J. A., additional, Johnston, C. F., additional, Buchanan, K. D., additional, Dean, G., additional, Elian, M., additional, Gray, W. P., additional, Ryder, D. Q., additional, Buckley, T. F., additional, Breathnach, K., additional, Ooi, A., additional, Farrell, M., additional, Doherty, C., additional, Hayes, F. J., additional, Redmond, J. J. T., additional, McKenna, M. M., additional, Gibson, J. M., additional, Patterson, V. H., additional, Moran, M., additional, Burke, M., additional, King, M. D., additional, Hardiman, O., additional, Reid, V., additional, Dowd, J. O., additional, Murphy, R., additional, Rashad, E., additional, Toland, J., additional, Phillips, J. P., additional, Shu-Ming, Peng, additional, Coughlin, A., additional, McCoy, D. M., additional, Qureshi, A., additional, Black, M. A., additional, Grace, P. A., additional, Bouchier-Hayes, D., additional, and Dwyer, R., additional

Published
1993
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45. Oncology implications for exercise and rehabilitation.

Author

Billek-Sawhney B and Wells CL

Abstract

The lifetime probability of developing cancer for men is 1 in 2 and for women is 1 in 3. Therefore, the acute care physical therapist is very likely to encounter numerous patients with cancer in various stages of diagnosis and treatment. This article serves as the second article in this issue, and follows, 'Oncology Considerations for the Patient in Acute Care.' The present article focuses on interpreting lab values and the important role of exercise in the cancer survivor. [ABSTRACT FROM AUTHOR]

Published
2009

46. Oncology considerations for the patient in acute care.

Author

Billek-Sawhney B and Wells CL

Abstract

In the United States, cancer is the second leading cause of death. Physical therapists commonly examine and treat patients with cancer in the acute care setting. This article provides the basis for understanding the incidence of cancer, common terminology, staging, and the medical management of patients with cancer. [ABSTRACT FROM AUTHOR]

Published
2009

48. Reliability of the Adapted Reach Test and its comparability to the Functional Reach Test in community-dwelling older adults.

Author

Billek-Sawhney B, Gay J, Wells CL, Sheakley J, and Rank S

Abstract

Limited space, deficient resources, or lack of familiarity with a test often lead to therapists modifying existing tools to fit their clinical needs. The Adapted Reach Test (ART) is a modification of the Functional Reach Test (FRT). The purpose of this study was to compare the FRT and the ART and to examine the intertester and test-retest reliability of the ART. A convenience sample of 30 community-dwelling residents (23 women, 7 men; aged 65-93) volunteered. Each participant performed the FRT as described in the literature with 1 practice trial and 3 measured trials; the mean score of the 3 trials was used as the FRT score for 1 testing session. This was repeated twice for the ART. The protocol for the ART was similar to that for the FRT, except that distance reached was marked on a manila folder. The mean FRT and ART measures for all participants were 8.2 +/- 3.2 in and 9.7 +/- 3.1 in, respectively; there was a statistically significant difference between FRT and ART results (P = .001). The Pearson correlation between the measures was 0.723. The intraclass correlation coefficients (2,3) comparing pairs of raters were all >=0.998. The kappa statistic ([kappa]) for the chance-corrected measure of agreement between the FRT and ART fall risk category rankings was 0.28. Although the relationship between the FRT and the ART was moderately high and both test-retest and interrater reliability were strong, the significant differences between FRT and ART measures precludes recommending the ART as an alternative to the FRT. Modification of established test protocols should therefore be undertaken with caution. [ABSTRACT FROM AUTHOR]

Published
2006
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49. Literacy and the older adult: educational considerations for health professionals.

Author

Billek-Sawhney B and Reicherter EA

Abstract

In the United States, there is a high rate of illiteracy disproportionately affecting older adults. This is compounded by chronic disease and sensory changes associated with aging. It is imperative that health professionals involved in the care of the older adult be aware of health illiteracy and be able to address these issues during the provision of care. This article provides an overview of health literacy issues impacting the rehabilitation of the older adult. It offers techniques for recognizing health illiteracy in patients and provides recommendations for creating appropriate patient education materials for this population. [ABSTRACT FROM AUTHOR]

Published
2005
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