37 research outputs found
sj-pdf-1-tor-10.1177_23978473211052700 – Supplemental Material for Retrospective analysis of adverse effects associated with pyrethrins-containing products
No full textSupplemental Material, sj-pdf-1-tor-10.1177_23978473211052700 for Retrospective analysis of adverse effects associated with pyrethrins-containing products by Thomas G Osimitz, Kelly Sioris, John Gualtieri, Dean Filandrinos, Ryan Seaverson, Angeline M Carlson, Wiebke Droege and Rick Kingston in Toxicology Research and Application</p
The relationship between overall utilization and settlements involving off-label promotion of prescription drugs
No full textUniversity of Minnesota Ph.D. dissertation. February 2013. Major: Social and Administrative Pharmacy. Advisors: Stephen W. Schondelmeyer and Angeline M. Carlson. 1 computer file (PDF); vii, 274 pages.Bilek, Jennell C.. (2013). The relationship between overall utilization and settlements involving off-label promotion of prescription drugs. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/146578
The Medical Home Model and Pediatric Asthma Symptom Severity: Evidence from a National Health Survey
No full textBack to the Future: Towards Ridge Filters in Clinical FLASH Proton Therapy Treatment Planning for Neuro-Oncological Targets
No full textFLASH proton therapy is a growing field of research, especially due to its biological benefits in radiation oncology: sparing healthy tissue while delivering the treatment within a millisecond. However, instead of sparing healthy tissue, the conventional FLASH approach, using transmission beams, damages the tissue behind the distal edge of a tumour. Therefore, this approach is less attractive in some clinical applications of FLASH proton therapy. To solve this problem, the use of a ridge filter and patient-specific range compensator, to shift the spread-out Bragg peak (SOBP) of the proton beam to the tumour, is proposed. In this research, the clinical feasibility and acceptability of FLASH-compatible treatment plans, optimized with multiple, Monte Carlo-simulated ridge filter beams, is analysed. An SOBP-database is generated using energy spectrum approximations and interpolations of energy spectra retrieved from Monte Carlo simulations in TOPAS. To obtain optimized FLASH-compatible treatment plans for neuro-oncological targets, this database is implemented in the in-house treatment planning software of the Erasmus Medical Center, iCycle. The resulting treatment plans show that it is possible to generate FLASH-compatible treatment plans using a ridge filter. A FLASH enhancement ratio between 1.4 and 2.1 would potentially give clinically acceptable plans for the three patients considered. In some optimized plans, the homogeneity of the tumour dose is also increased. A limitation of this research is that configuration of a stable ridge filter beam treatment plan optimizer appears to be challenging. Besides this, the FLASH enhancement ratio and the dose rate are not taken into account to find the regions in the patient where the FLASH conditions (dose > 8 Gy, dose rate > 40 Gy/s and treatment time < 0.1 s) are met. Recommendations for future research include: implementing the FLASH enhancement ratio and the dose rate optimization in treatment plan optimization; investigating the influence of fractionation ofa FLASH treatment plan on the tumour control and the healthy tissue irradiated; study the relative biological effectiveness (RBE) and the biological character of FLASH radiotherapy, and investigate the clinical potential of a combination of FLASH and non-FLASH treatment. Applied Science
Eating to add years of life and life to these years: what should be in the menu? [editorial].
No full textThe author Elena Gonzalez Rodriguez is not properly referenced in PubMed. The reference shows as "Rodriguez E.G.", but should be "Gonzalez Rodriguez E.". - Comment on: Diet quality as a predictor of cardiometabolic disease-free life expectancy: the Whitehall II cohort study. Auteurs: Lagström H, Stenholm S, Akbaraly T, Pentti J, Vahtera J, Kivimäki M, Head J.
Am J Clin Nutr. 2020 Apr 1;111(4):787-794. doi: 10.1093/ajcn/nqz329
Pharmacy Practice in the South Dakota Correctional System: Discovery of an Unconventional Experiential Practice Site
No full textPharmacists must be prepared to care for populations where health disparities are greatest and their services can best impact public health needs. Such preparation requires that students have access to practice experiences in underserved environments where pharmacy practice, cultural competence and knowledge of population health are experienced simultaneously. The correctional facility is such a place.
The American Society of Health-System Pharmacists recommends that students receive preceptorship opportunities within the correctional system. The occasional collaboration or experiential opportunity, like Kingston’s early model, has occurred between health professional schools and correctional facilities. However, to date, the correctional facility-experiential site remains an untapped opportunity, at least in a complete, coordinated, pharmaceutical care, patient management framework. Consequently, a short research study asked: To what extent is there potential for correctional facilities to serve as experiential practice sites for pharmacy students? The research objective was to identify pharmaceutical practices within South Dakota correctional system and compare those practices to the guidelines established by the Association of American College of Pharmacy’s as optimal for student training. To understand medical and pharmaceutical practices in SDPS, three South Dakota Adult prison facilities were included in the exploratory study. Data was collected through a mixed methods approach designed to obtain perspectives about the SDPS health care system from individuals representing the numerous job levels and roles that exist within the health care continuum. Interviews and a web-based surveys were used to collect data. A review of a 36-page transcript along with 498 freeform survey comments revealed that while exact themes from the Exemplary Practice Framework may not have been evident, related words or synonyms for patient-centered care, informatics, public health, medication therapy management, and quality improvement appeared with great frequency.
Article type: Original Researc
Disparities in SGLT2 Inhibitor or Glucagon-Like Peptide 1 Receptor Agonist Initiation Among Medicare-Insured Adults With CKD in the United StatesPlain-Language Summary
No full textRationale & Objective: Information regarding disparities in initiating sodium/glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1RA) in patients with chronic kidney disease (CKD) is limited. We examined sociodemographic and clinical factors associated with the initiation of SGLT2i, GLP-1RA, or second-generation sulfonylureas in a Medicare Fee-For-Service patient population with CKD and type 2 diabetes. Study Design: Retrospective cohort study. Setting & Participants: The 20% random sample of Medicare Fee-For-Service claims, 2012-2018. Exposures: Patients’ sociodemographic and clinical factors. Outcomes: Use of SGLT2i, GLP-1RA, or sulfonylureas. Analytical Approach: Patients with a newly initiated prescription of SGLT2i, GLP-1RA, or second-generation sulfonylureas from January 1, 2013, to December 31, 2018, were identified. Multinomial logistic regression model was used to evaluate demographic and clinical factors associated with the initiation of SGLT2i, GLP-1RA, or second-generation sulfonylureas. Results: The study cohort comprised 53,029 adults (aged greater than or equal to 18 years) with CKD and type 2 diabetes, of whom 10.0%, 17.4%, and 72.6% had a first prescription for SGLT2i, GLP-1RA, and sulfonylurea, respectively. Patients aged greater than or equal to 75 years versus those aged 65-74 years had lower odds to start SGLT2i or GLP-1RA compared with sulfonylureas. Black patients were associated with lower odds of initiation of SGLT2i (OR, 0.67; 95% CI, 0.61-0.74) and GLP-1RA (OR, 0.73; 95% CI, 0.68-0.79), compared with White patients. Hispanic and Asian patients had lower odds of initiation of GLP-1RA. Patients with cardiovascular disease or hyperlipidemia had higher odds to start SGLT2i or GLP-1RA. Limitations: CKD and type 2 diabetes diagnosis; CKD stage; and patient clinical status were identified with diagnosis or procedure codes. There is potential for residual confounding with the use of retrospective data. Conclusions: The results of this study identified disparities in the use of SGLT2i and GLP-1RA in patients with CKD. Black and older patients were significantly less likely to be initiated on SGLT2i or GLP-1RA than on second-generation sulfonylureas
Chronic medication adherence: its association with health care costs.
No full textUniversity of Minnesota Ph.D. dissertation. August 2011. Major: Social and Administrative Pharmacy. Advisors: Jon C. Schommer, Ph.D., Angeline M. Carlson, Ph.D., 1 computer file (PDF);xiv, 141 pages, appendices 1-2.Effective treatment for high-prevalence chronic diseases requires medication adherence. Improved medication adherence increases medication utilization, which leads to higher pharmacy costs. However, higher adherence may reduce medical services use that result in decrease in overall health care costs despite the increase in pharmacy costs.
The objective of this study was to examine the impact of medical adherence on health care costs. The secondary objective of this study was to assess the independent effect of consumer directed health plans (CDHPs) on health care costs. The study samples were three independent cohorts of individuals with the separate conditions of diabetes, hypertension and hypercholesterolemia, identified from a pharmacy benefits management company between January 1, 2007 and December 31, 2009. Medication adherence was measured using Proportion of Days Covered (PDC) endorsed by Pharmacy Quality Assurance (PQA). Health care costs were measured at two levels: all-cause and condition-specific. At each level, pharmacy, medical and total health care costs were calculated. The generalized linear model with a gamma log link was used to fit six statistical models for each disease cohort. Control variables included patients’ demographics, socioeconomic information, health status, health services utilization. There were 22,012 individuals in the diabetes cohort, 64,600 in the hypertension cohort and 59,003 in the hypercholesterolemia cohort. At all-cause level, increased PDC was significant associated with decreased medical costs across the three cohorts (p<0.05). At condition-specific level, increased PDC was significant associated with decreased medical costs in the hypertension and hypercholesterolemia cohorts (p<0.001), but with increased medical cost in the diabetes cohort (p<0.001). Due to the significant increase in pharmacy costs associated with higher PDC (p<0.001), total health care costs were increased (p<0.001) both at all-cause and condition-specific levels in each cohorts. Enrollment in CDHPs was generally associated with decreased medical, pharmacy, and total health care costs at all-cause and condition-specific levels across the three cohorts.
As adherence increases, the savings in medical costs are not able to offset the increase in pharmacy costs. Therefore, measures that aim to reduce pharmacy cost while preserving or improving adherence are needed.Zhou, Siting. (2011). Chronic medication adherence: its association with health care costs.. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/116564
