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  • 1
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    Online Resource
    International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module
    Elsevier BV ; 2014
    In:  American Journal of Infection Control Vol. 42, No. 9 ( 2014-09), p. 942-956
    Details
    In: American Journal of Infection Control, Elsevier BV, Vol. 42, No. 9 ( 2014-09), p. 942-956
    Type of Medium: Online Resource
    ISSN: 0196-6553
    URL: Article
    DOI: 10.1016/j.ajic.2014.05.029
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2014
    detail.hit.zdb_id: 2011724-3
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  • 2
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    All-Cause Health Care and Work Loss Burden Associated With Nonsteroidal Anti-Inflammatory Drug and Opioid Treatment in Employed Patients With Osteoarthritis
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Journal of Occupational & Environmental Medicine Vol. 64, No. 8 ( 2022-8), p. 699-706
    Details
    In: Journal of Occupational & Environmental Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 64, No. 8 ( 2022-8), p. 699-706
    Abstract: This study estimated all-cause health care resource utilization (HRU) and costs and work loss outcomes associated with pain management of employed patients with osteoarthritis of the hip and/or knee. Methods Optum Health Care Solutions data were analyzed for employed patients prescribed nonsteroidal anti-inflammatory drugs, tramadol, or nontramadol opioids following diagnoses of osteoarthritis of the hip and/or knee. A pre-post design was used to evaluate changes in all-cause HRU and costs, and work loss days and associated costs. Results Costs rose for patients in all three cohorts (up to 198.3% for health care costs [tramadol] and up to 178.7% for work loss costs [tramadol] ). Greatest increases in all-cause HRU included inpatient visits (237.9% [nonsteroidal anti-inflammatory drugs]; 600% [tramadol] ). Conclusions Study results provide evidence of increases in all-cause HRU and costs and work loss days and associated costs.
    Type of Medium: Online Resource
    ISSN: 1076-2752 , 1536-5948
    URL: Article
    DOI: 10.1097/JOM.0000000000002568
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2070230-9
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  • 3
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    Risk Factors Associated With Falls and Fractures Following Prescription of Opioids Among Privately Insured Patients With Osteoarthritis
    The Journal of Health Economics and Outcomes Research ; 2022
    In:  Journal of Health Economics and Outcomes Research Vol. 9, No. 2 ( 2022-8-19), p. 47-56
    Details
    In: Journal of Health Economics and Outcomes Research, The Journal of Health Economics and Outcomes Research, Vol. 9, No. 2 ( 2022-8-19), p. 47-56
    Abstract: Background: While prior research has shown that patients with osteoarthritis (OA) who are prescribed opioids have higher rates of falls and fractures following drug initiation, there is a limited body of work establishing a comprehensive model of factors that influence the risk of falls or fractures among these patients. Objective: Opioids are associated with negative clinical outcomes, including increased risk of falls and fractures. This study assessed the frequency, treatment characteristics, and risk factors associated with falls or fractures among patients with OA taking opioids. Methods: Optum Healthcare Solutions, Inc data (January 2012–March 2017) were used to identify patients over 18 with at least 2 diagnoses of hip and/or knee OA, and at least 90 days’ supply of opioids. Patients with cancer were excluded. Falls or fractures outcomes were assessed in the 36-month follow-up period after the date of the first opioid prescription after first OA diagnosis. Demographic, treatment, and clinical characteristics associated with falls or fractures were assessed using logistic regression. Results: Of 16 663 patients meeting inclusion criteria, 3886 (23%) had at least 1 fall or fracture during follow-up. Of these 3886 patients, 1349 (35%) had at least 1 fall with an average of 3 fall claims, and 3299 (85%) patients had at least 1 fracture with an average of 8 claims during follow-up. Spine (15.8%) and hip (12.5%) fractures were most common. Median time to fall or fracture was 18.6 and 13.9 months, respectively. Significant (P 〈 .05) risk factors associated with at least 1 fall or fracture during the follow-up period included alcohol use (odds ratio [OR] , 3.41), history of falling (OR, 2.19), non-tramadol opioid use (OR, 1.31), age (OR, 1.03), benzodiazepine use (OR, 1.21), and at least 1 osteoporosis diagnosis (OR, 2.06). Discussion: This study is among only a few that clearly identifies the substantial impact and frequency of falls and fractures associated with prescribing non-tramadol opioids to patients with OA. Findings suggest that fall or fracture risks need to be considered when managing OA pain with opioids. Conclusion: Falls and fractures impose a major clinical burden on patients prescribed opioids for OA-related pain management. Falls or fracture risks should be an important consideration in the ongoing treatment of patients with OA.
    Type of Medium: Online Resource
    ISSN: 2327-2236
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.36469/jheor.2022
    DOI: 10.36469/00001
    DOI: 10.36469/jheor.2022.32584
    Language: English
    Publisher: The Journal of Health Economics and Outcomes Research
    Publication Date: 2022
    detail.hit.zdb_id: 2746906-2
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  • 4
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    Evaluating oncologists’ practice patterns and decision-making in locally advanced or metastatic urothelial carcinoma (la/mUC): The U.S. physician PARADIGM study (Part 2).
    American Society of Clinical Oncology (ASCO) ; 2022
    In:  Journal of Clinical Oncology Vol. 40, No. 16_suppl ( 2022-06-01), p. 4595-4595
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 40, No. 16_suppl ( 2022-06-01), p. 4595-4595
    Abstract: 4595 Background: The treatment (tx) landscape for la/mUC has evolved with the use of immunotherapy (IO) for platinum-refractory la/mUC as well as first-line (1L) maintenance therapy (1LM). This cross-sectional survey explored practice patterns for 1L tx/1LM use and clinical decision-making. Methods: Community/academic US oncologists (n = 150) completed an online survey (Sept-Oct 2021) on demographics, 1L tx, 1LM use, attributes in 1L tx selection/1LM use, and factors associated with 1L tx/1LM use. Physicians were dichotomized into 4 pre-specified groups using the median percentage (%) as a cutoff: 1) more frequent 1L prescriber 2) less frequent 1L prescriber (% of pts treated with 1L tx in the past 6 months); 3) more frequent 1LM prescriber 4) less frequent 1LM prescriber (% of pts eligible and received 1LM). Descriptive and bivariate analyses assessing attributes (scored out of 100 points across 16 attributes) in 1L tx selection/1LM use were conducted. Multivariable logistic regression was used to assess factors associated with more/less frequent 1L tx/1LM use. Results: Median time in practice was 15 yrs (range, 2-31; 63% community vs 37% academic setting). The median % of la/mUC pts who received 1L tx was 46% (range, 25-89%). 72 physicians were categorized as more frequent 1L prescribers, while 78 were less frequent 1L prescribers. The median % of pts eligible and received 1LM was 71% (range, 0-100%). 71 physicians were categorized as more frequent 1LM prescribers, while 75 were less frequent 1LM prescribers. Attributes used in 1L tx selection differed among more vs less frequent 1L prescribers: mean scores for efficacy/overall survival (OS), disease control rate (DCR), or rate of grade 3/4 adverse events (AEs) were 23 vs 17, 10 vs 8, and 10 vs 5, respectively (all p 〈 0.05). Similarly, for more vs less frequent 1LM prescribers, mean scores for efficacy/OS, rate of grade 3/4 immune-mediated AEs, and inclusion in institutional guidelines/pathways were 23 vs 16, 6 vs 4, and 2 vs 4. Oncologists who stated OS, DCR, or rate of grade 3/4 AEs as important factors impacting tx selection were more likely to prescribe 1L tx (all p 〈 0.05). Regarding 1LM use, oncologists based in the academic setting, those who reported using RECIST 1.1 criteria to assess tx response or agreed 1LM is important to prolong OS were all more likely to prescribe 1LM (all p 〈 0.05). Those who reported that their institutional guidelines/pathways impact tx decisions or cited prior IO use before metastatic diagnosis as reason not to prescribe 1LM were less likely to prescribe 1LM (all p 〈 0.05). Conclusions: While several factors were found to be associated with offering 1L tx by US oncologists, including impact on OS and practice setting, variability exists in physicians’ attitudes to 1L tx/1LM use. Studies and interventions to explore shared decision-making for optimal 1L tx selection are needed.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2022.40.16_suppl.4595
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2022
    detail.hit.zdb_id: 2005181-5
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  • 5
    Online Resource
    Online Resource
    Risk Factors Associated with Falls and Fractures Following Prescription of Opioids Among Privately Insured Patients with Osteoarthritis
    The Journal of Health Economics and Outcomes Research ; 2022
    In:  Journal of Health Economics and Outcomes Research Vol. 9, No. 2 ( 2022-8-19)
    Details
    In: Journal of Health Economics and Outcomes Research, The Journal of Health Economics and Outcomes Research, Vol. 9, No. 2 ( 2022-8-19)
    Abstract: Background: While prior research has shown that patients with osteoarthritis (OA) who are prescribed opioids have higher rates of falls and fractures following drug initiation, there is a limited body of work establishing a comprehensive model of factors that influence the risk of falls or fractures among these patients. Objective: Opioids are associated with negative clinical outcomes, including increased risk of falls and fractures. This study assessed the frequency, treatment characteristics, and risk factors associated with falls or fractures among patients with OA taking opioids. Methods: Optum Healthcare Solutions, Inc data (January 2012–March 2017) were used to identify patients over 18 with at least 2 diagnoses of hip and/or knee OA, and at least 90 days’ supply of opioids. Patients with cancer were excluded. Falls or fractures outcomes were assessed in the 36-month follow-up period after the date of the first opioid prescription after first OA diagnosis. Demographic, treatment, and clinical characteristics associated with falls or fractures were assessed using logistic regression. Results: Of 16 663 patients meeting inclusion criteria, 3886 (23%) had at least 1 fall or fracture during follow-up. Of these 3886 patients, 1349 (35%) had at least 1 fall with an average of 3 fall claims, and 3299 (85%) patients had at least 1 fracture with an average of 8 claims during follow-up. Spine (15.8%) and hip (12.5%) fractures were most common. Median time to fall or fracture was 18.6 and 13.9 months, respectively. Significant ( P 〈 .05) risk factors associated with at least 1 fall or fracture during the follow-up period included alcohol use (odds ratio [OR], 3.41), history of falling (OR, 2.19), non-tramadol opioid use (OR, 1.31), age (OR, 1.03), benzodiazepine use (OR, 1.21), and at least 1 osteoporosis diagnosis (OR, 2.06). Discussion: This study is among only a few that clearly identifies the substantial impact and frequency of falls and fractures associated with prescribing non-tramadol opioids to patients with OA. Findings suggest that fall or fracture risks need to be considered when managing OA pain with opioids. Conclusion: Falls and fractures impose a major clinical burden on patients prescribed opioids for OA-related pain management. Falls or fracture risks should be an important consideration in the ongoing treatment of patients with OA.
    Type of Medium: Online Resource
    ISSN: 2327-2236
    URL: Article
    DOI: 10.36469/001c.32584
    Language: English
    Publisher: The Journal of Health Economics and Outcomes Research
    Publication Date: 2022
    detail.hit.zdb_id: 2746906-2
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  • 6
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    Online Resource
    Prescription opioid utilization patterns, and associated outcomes, among privately insured patients prescribed opioids to manage pain associated with osteoarthritis
    Informa UK Limited ; 2023
    In:  Current Medical Research and Opinion Vol. 39, No. 8 ( 2023-08-03), p. 1147-1156
    Details
    In: Current Medical Research and Opinion, Informa UK Limited, Vol. 39, No. 8 ( 2023-08-03), p. 1147-1156
    Type of Medium: Online Resource
    ISSN: 0300-7995 , 1473-4877
    URL: Article
    DOI: 10.1080/03007995.2023.2234727
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2023
    detail.hit.zdb_id: 2034331-0
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  • 7
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    Online Resource
    The Burden of Metastatic Cancer–Induced Bone Pain: A Narrative Review
    Informa UK Limited ; 2022
    In:  Journal of Pain Research Vol. Volume 15 ( 2022-10), p. 3399-3412
    Details
    In: Journal of Pain Research, Informa UK Limited, Vol. Volume 15 ( 2022-10), p. 3399-3412
    Type of Medium: Online Resource
    ISSN: 1178-7090
    URL: Article
    DOI: 10.2147/JPR.S371337
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2022
    detail.hit.zdb_id: 2495284-9
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  • 8
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    Use of electronic health data to identify patients with moderate-to-severe osteoarthritis of the hip and/or knee and inadequate response to pain medications
    Springer Science and Business Media LLC ; 2023
    In:  BMC Medical Research Methodology Vol. 23, No. 1 ( 2023-06-30)
    Details
    In: BMC Medical Research Methodology, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2023-06-30)
    Abstract: No algorithms exist to identify important osteoarthritis (OA) patient subgroups (i.e., moderate-to-severe disease, inadequate response to pain treatments) in electronic healthcare data, possibly due to the complexity in defining these characteristics as well as the lack of relevant measures in these data sources. We developed and validated algorithms intended for use with claims and/or electronic medical records (EMR) to identify these patient subgroups. Methods We obtained claims, EMR, and chart data from two integrated delivery networks. Chart data were used to identify the presence or absence of the three relevant OA-related characteristics (OA of the hip and/or knee, moderate-to-severe disease, inadequate/intolerable response to at least two pain-related medications); the resulting classification served as the benchmark for algorithm validation. We developed two sets of case-identification algorithms: one based on a literature review and clinical input (predefined algorithms), and another using machine learning (ML) methods (logistic regression, classification and regression tree, random forest). Patient classifications based on these algorithms were compared and validated against the chart data. Results We sampled and analyzed 571 adult patients, of whom 519 had OA of hip and/or knee, 489 had moderate-to-severe OA, and 431 had inadequate response to at least two pain medications. Individual predefined algorithms had high positive predictive values (all PPVs ≥ 0.83) for identifying each of these OA characteristics, but low negative predictive values (all NPVs between 0.16–0.54) and sometimes low sensitivity; their sensitivity and specificity for identifying patients with all three characteristics was 0.95 and 0.26, respectively (NPV 0.65, PPV 0.78, accuracy 0.77). ML-derived algorithms performed better in identifying this patient subgroup (range: sensitivity 0.77–0.86, specificity 0.66–0.75, PPV 0.88–0.92, NPV 0.47–0.62, accuracy 0.75–0.83). Conclusions Predefined algorithms adequately identified OA characteristics of interest, but more sophisticated ML-based methods better differentiated between levels of disease severity and identified patients with inadequate response to analgesics. The ML methods performed well, yielding high PPV, NPV, sensitivity, specificity, and accuracy using either claims or EMR data. Use of these algorithms may expand the ability of real-world data to address questions of interest in this underserved patient population.
    Type of Medium: Online Resource
    ISSN: 1471-2288
    URL: Article
    DOI: 10.1186/s12874-023-01964-y
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2041362-2
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  • 9
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    PATRIOT II: An ambispective, observational, multicenter, 2-cohort study of avelumab (Ave) first-line maintenance (1LM) in locally advanced/metastatic urothelial carcinoma (la/mUC) in the United States.
    American Society of Clinical Oncology (ASCO) ; 2022
    In:  Journal of Clinical Oncology Vol. 40, No. 6_suppl ( 2022-02-20), p. TPS578-TPS578
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 40, No. 6_suppl ( 2022-02-20), p. TPS578-TPS578
    Abstract: TPS578 Background: The randomized phase 3 JAVELIN Bladder 100 trial demonstrated overall and progression-free survival (OS and PFS) benefit with Ave 1LM for la/mUC not progressed with platinum-containing chemotherapy (PCT). PATRIOT II aims to understand real-world treatment (tx) patterns, patient-reported outcomes (PRO), and healthcare resource utilization (HCRU; eg, hospitalizations and emergency department visits) before and during Ave 1LM treatment. Methods: PATRIOT II is an ongoing, real-world, observational study in ≤25 US oncology centers with 1) an ambispective cohort of patients (pts) initiating PCT (n = 100), a subset of whom may continue to Ave 1LM and 2) a retrospective cohort initiated on Ave 1LM (n = 150). Sample size assumes noninferiority in HCRU and PRO pre and post 1LM initiation using paired t-tests with effect size of ≤0.3 as noninferior: ≥71 patients continuing to 1LM. In the ambispective cohort, pts with histologically confirmed la/mUC newly initiating 1L PCT are enrolled. While pts are receiving PCT and 1LM (for those who receive it), data will be collected on disease characteristics, response to tx, survival, adverse events (AEs), and HCRU for ≤52 wks after study initiation. PROs are captured using Rand SF-36 question 1, FACT Bladder Symptom Inventory – 18 and Cancer Treatment Satisfaction Questionnaire. Primary outcomes include OS and PFS from both PCT and 1LM initiation; secondary outcomes are changes in PROs and HCRU from PCT to 1LM. Analysis will be conducted at following time points: 1) baseline characteristics after full enrollment; 2) 6 months after study initiation to assess tx changes and rationale, OS, PFS, HCRU, and PRO changes from baseline; 3) at study conclusion (wk 52 after study initiation). In the retrospective cohort, pts with la/mUC who initiated Ave 1LM are enrolled. Chart data encompasses PCT and 1LM periods. Disease characteristics, response to tx, survival, AEs, and HCRU are collected. Primary outcomes are OS and PFS from initiation of PCT and 1LM start. Secondary outcomes are changes in HCRU before and after 1LM. Analysis will be conducted at following time points: 1) baseline characteristics after full enrollment, PCT, and response to tx; 2) 6 months after study initiation to assess tx changes since baseline, including dose changes, tx discontinuation/change rationale, survival rates (censoring for differential duration of follow-up), and HCRU outcomes; 3) at study conclusion to analyze endpoints up to wk 52 following study initiation. Analyses for both cohorts include Kaplan-Meier and Cox regression for time-to-event endpoints and paired t-tests for pre/post 1LM. Enrollment commenced in June 2021. 5 and 18 pts are enrolled to date in the ambispective and retrospective cohorts, respectively, from 6 of 11 activated sites. Initial results are anticipated in May 2022.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2022.40.6_suppl.TPS578
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2022
    detail.hit.zdb_id: 2005181-5
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  • 10
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    Racial variation in healthcare resource utilization and expenditures in knee/hip osteoarthritis patients: a retrospective analysis of a Medicaid population
    Informa UK Limited ; 2023
    In:  Journal of Medical Economics Vol. 26, No. 1 ( 2023-12-31), p. 1047-1056
    Details
    In: Journal of Medical Economics, Informa UK Limited, Vol. 26, No. 1 ( 2023-12-31), p. 1047-1056
    Type of Medium: Online Resource
    ISSN: 1369-6998 , 1941-837X
    URL: Article
    DOI: 10.1080/13696998.2023.2245298
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2023
    detail.hit.zdb_id: 2156786-4
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