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Journal Current Medical Research and Opinion

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Sarah E. Holden, Alyn Morice, Surinder S. Birring, Sara Jenkins-Jones, Haya Langerman, Jessica Weaver, Craig J. Currie
Current Medical Research and Opinion pp 1-12; doi:10.1080/03007995.2019.1673716

The publisher has not yet granted permission to display this abstract.
Qian Cai, John J. Sheehan, Bingcao Wu, Larry Alphs, Nancy Connolly, Carmela Benson
Current Medical Research and Opinion pp 1-7; doi:10.1080/03007995.2019.1671087

Abstract:Objectives: To assess characteristics and healthcare costs associated with pharmacologically-treated episodes of treatment-resistant depression (TRD) in patients with major depressive disorder (MDD). Methods: Patients aged ≥18 years with continuous health plan enrollment for ≥12 months before and after a newly observed MDD diagnosis (observed between 1/1/2010 and 12/31/2015) were included in this retrospective claims-based analysis. A pharmacologically-treated episode was defined as beginning at the date of the first MDD diagnosis and ending when a gap of 180 days occurred between MDD diagnoses, or when a gap of 180 days occurred following the end of the antidepressant (AD)/antipsychotic (AP) drug supply. When such a gap occurred, the episode end date was determined to be either the date of the last MDD diagnosis or date of the end of AD/AP drug supply, whichever was later. An episode was considered TRD if ≥3 AD regimens occurred. Episode duration, medication regimens used, and relapse hospitalization were reported for TRD and non-TRD MDD episodes. Total all-cause and per-patient-per-month (PPPM) healthcare costs (in 2016 $) were estimated. Results: Of 48,440 patients identified with ≥1 AD-treated MDD episode, the mean (SD) age was 39 (15) years, and 62% were female. Of all episodes, 7% were TRD, with a mean duration of 571 (285) days vs. 200 (198) days for non-TRD MDD episodes. Mean total all-cause costs were $19,626 ($44,160) for TRD and $7,440 ($25,150) for non-TRD MDD episodes. Conclusions: Results show TRD episodes are longer and costlier than non-TRD MDD episodes, and that higher costs are driven by episode duration. Longer episodes imply protracted suffering for patients with TRD and increased burden on caregivers. Effective intervention to shorten TRD episodes may lessen disease burden and reduce costs.
R A Chudleigh, S C Bain
Current Medical Research and Opinion pp 1-1; doi:10.1080/03007995.2019.1678344

Abhishek S. Chitnis, Piyush Nandwani, Jill Ruppenkamp, Mollie Vanderkarr, Chantal E. Holy
Current Medical Research and Opinion pp 1-7; doi:10.1080/03007995.2019.1667315

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Rosalba Rosato, Daniela Di Cuonzo, Giuliana Ritorto, Laura Fanchini, Sara Bustreo, Patrizia Racca, Eva Pagano
Current Medical Research and Opinion pp 1-9; doi:10.1080/03007995.2019.1670475

The publisher has not yet granted permission to display this abstract.
Bimal R. Shah, Maral DerSarkissian, Stelios I. Tsintzos, Yongling Xiao, Damian May, Xiaoxiao Lu, David Kinrich, Eric Davis, Patrick Lefebvre, Mei S. Duh, et al.
Current Medical Research and Opinion pp 1-9; doi:10.1080/03007995.2019.1670474

Abstract:OBJECTIVE: The purpose of this study is to assess the real-world impact of cardiac resynchronization therapy (CRT) on adherence to heart failure (HF) medications. METHODS: MarketScan® administrative health care claims data from 2008 to 2014 among patients with HF were used. The date of first CRT implantation served as the index date. Adherence to guideline-directed medical therapy (GDMT) classes were compared during pre- and post-index periods using proportion of days covered (PDC). Comparisons between the two periods were made using the Wilcoxon sign-rank test for continuous PDC and McNemar's test for dichotomized PDC. RESULTS: Increases in medication adherence were observed for major classes of HF GDMT medications. Specifically, adherence to angiotensin-converting enzyme inhibitors (ACE-I), angiotensin receptor blockers (ARB), beta blockers (BB), and furosemide increased by 22%, 24%, 32%, and 28% (all p < 0.001), respectively, in the 12 months pre to 12 months post-CRT. Large increases between the pre- and post-CRT period were also observed when considering adherence as dichotomized PDC ≥0.80 in the 12 months pre- versus post-CRT. CONCLUSION: Adherence to HF medications significantly improved among HF patients post-CRT implantation. Further research is needed to better understand the underlying determinants of this effect, including whether the effect is attributable to factors such as enhanced patient monitoring and improved access to high-quality specialized HF care among patients receiving CRT.
Dirk Deleu, Beatriz Canibaño, Boulenouar Mesraoua, Gholamreza Adeli, Mohamed S. Abdelmoneim, Yasir Ali, Osama Elalamy, Gayane Melikyan, Amir Boshra
Current Medical Research and Opinion pp 1-10; doi:10.1080/03007995.2019.1669378

Abstract:Healthcare systems vary greatly between countries. International, evidence-based guidelines for the management of multiple sclerosis (MS) may need to be adapted for use in particular countries. Two years ago, the authors published a comprehensive consensus guideline for the management of MS in Qatar. Since that time, the availability of disease-modifying treatments for relapsing-remitting MS (RRMS), and our understanding of how to apply those treatments, has increased. The authors present an update to our guidance, focussing on the management of relapsing-remitting RRMS. In particular, the authors consider the optimal use of different DMTs in patients presenting with mild, medium or high disease activity.
Cristoforo Incorvaia, Bruna L. Gritti, Erminia Ridolo
Current Medical Research and Opinion pp 1-1; doi:10.1080/03007995.2019.1676576

Byoung Chul Cho, Dong-Wan Kim, Keunchil Park, Jong-Seok Lee, Seung Soo Yoo, Jin Hyoung Kang, Sung Yong Lee, Cheol Hyeon Kim, Seung Hun Jang, Young-Chul Kim, et al.
Current Medical Research and Opinion pp 1-1; doi:10.1080/03007995.2019.1676708

The publisher has not yet granted permission to display this abstract.
Luis Cea-Calvo, Ignacio Marín-Jiménez, Javier De Toro, María J. Fuster-RuizdeApodaca, Gonzalo Fernández, Nuria Sánchez-Vega, Domingo Orozco-Beltrán
Current Medical Research and Opinion pp 1-1; doi:10.1080/03007995.2019.1676539

Abstract:Background: The objective of the current work was to assess the frequency of non-adherence behaviors and potential association with patients’ experience with healthcare and beliefs in medicines self-reported by patients with four different chronic conditions. Methods: Patients responded anonymously to a survey comprising five non-adherence behaviors (based on physician and patient input), an assessment of patients’ experience with healthcare using the validated Instrument to Evaluate the EXperience of PAtients with Chronic diseases (IEXPAC), and a validated Spanish version of the Beliefs about Medicines Questionnaire (BMQ). Associations of non-adherence behavior were analyzed using logistic regression models. Results: Of 1,530 respondents, 53.1% reported ≥1 non-adherence behavior. Non-adherence rates were 59.8% in diabetes mellitus (DM), 56.0% in rheumatic disease, 55.6% in inflammatory bowel disease, and 42.8% in human immunodeficiency virus (HIV) infection patients (p < .001). IEXPAC and BMQ scores were higher in adherent vs. non-adherent patients. In multivariate analysis, non-adherence behavior was strongly associated with lower overall BMQ, lower BMQ Necessity scores and higher BMQ Concerns scores (p < .001 for all), and with a lower IEXPAC self-management score (p = .007), but not with the overall IEXPAC score. Non-adherence was more frequent in DM patients compared with HIV infection patients (p < .001). Conclusions: Patients’ beliefs in medicines - a lower perception for the necessity of medication, and higher concerns in taking medication - and low patient self-management experience score were associated with non-adherence behavior. These are modifiable aspects that need to be addressed to increase medication adherence in chronic disease.
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