Impact of baseline heart failure burden on post-implantable cardioverter-defibrillator mortality among medicare beneficiaries
Objectives: This study sought to assess the impact of baseline heart failure (HF) burden on survival with primary implantable cardioverter- defibrillator (ICD) among Medicare recipients. Background: Survival after primary ICD implantation may differ between trial and Medicare populations.
National trends in antidepressant medication treatment among publicly insured pregnant women
Objective: The risk of depression in women is greatest at childbearing age. We sought to examine and explain national trends in antidepressant use in pregnant women.
Opioid use for noncancer pain and risk of myocardial infarction amongst adults
Backgrounds: With increasing use of opioids for chronic noncancer pain comes concern about safety of this class of drugs. Opioid-induced hypogonadism, which could increase the risk for myocardial infarction (MI), has recently come to the attention of clinicians.
Enrollment and events of hospice patients with heart failure vs. cancer
Context: Hospice care is traditionally used for patients with advanced cancer, but it is increasingly considered for patients with end-stage heart failure. Objectives: We compared enrollment patterns and clinical events of hospice patients with end-stage heart failure with those of patients with advanced cancer.
Follow-up of patients with new cardiovascular implantable electronic devices: Are experts’ recommendations implemented in routine clinical practice?
Background – A 2008 expert consensus statement outlined the minimum frequency of follow-up of patients with cardiovascular implantable electronic devices (CIEDs). Methods and Results – We studied 38 055 Medicare beneficiaries who received a new CIED between January 1, 2005, and June 30, 2009. The main outcome measure was variation of follow-up by patient factors and year of device implantation.
Epidemiologic and Statistical Methods for Comparative Effectiveness Research
Observational methods are evolving in response to the widespread availability of data from clinical registries, electronic health records, and administrative databases. These approaches will never eliminate the need for randomized trials, but clearly have a role in evaluating the effect of therapies in unselected populations treated in routine practice. This article reviews several approaches to the analysis of observational data that are in common use, or that may have promise even though they are not yet often applied.
Heart failure: Transitional adherence and persistence in the use of aldosterone antagonist therapy in patients with heart failure
Background Aldosterone antagonist therapy is recommended for selected patients with heart failure and reduced ejection fraction. Adherence to therapy in the transition from hospital to home is not well understood.
Simultaneous vs Staged bilateral total knee arthroplasty among medicare beneficiaries, 2000-2009
Simultaneous bilateral total knee arthroplasty (TKA) reportedly has higher postoperative complication rates than staged procedures, but little is known about recent trends and outcomes among Medicare patients.
Who enrolls in the medicare part D prescription drug benefit program? Medication use among patients with heart failure
Background–Dispensing data from Medicare Part D standalone prescription drug plans are now available, but characteristics of enrollees with heart failure have not been well described.
Scaling up pediatric HIV care and treatment in Africa: Clinical site characteristics associated with favorable service utilization
Background: To improve pediatric enrollment and retention in HIV treatment programs in Africa, we examined factors associated with service utilization within the Elizabeth Glaser Pediatric AIDS Foundation program in Côte d’Ivoire, Mozambique, South Africa, Tanzania and Zambia.
Algorithms to estimate the beginning of pregnancy in administrative databases
Purpose: The role of administrative databases for research on drug safety during pregnancy can be limited by their inaccurate assessment of the timing of exposure, as the gestational age at birth is typically unavailable. Therefore, we sought to develop and validate algorithms to estimate the gestational age at birth using information available in these databases.
Antidepressant Adherence among Latinos: The Role of the Family
Familismo (familism) has been introduced in various ways in Latino mental health. For people with mental illnesses such as depression, familism can create pressures that are treatment discouraging.
Comparative cardiovascular safety of dementia medications: A cross-national study
Objectives To compare the cardiovascular safety of currently marketed dementia medications in new users in the United States and Denmark. Design Retrospective cohort study. Setting Nationally representative sample of Medicare beneficiaries from 2006 through 2009 and nationwide Danish administrative registries from 1997 through 2007.
How the global call for elimination of pediatric HIV can support HIV-positive women to achieve their pregnancy intentions
The global call to eliminate new pediatric HIV infections requires a comprehensive approach, including consideration of the pregnancy intentions of HIV-positive women.
Implications of m bias in epidemiologic studies: A simulation study
Collider-stratification bias arises from conditioning on a variable (collider) which opens a path from exposure to outcome. M bias occurs when the collider-stratification bias is transmitted through ancestors of exposure and outcome.
Outcomes associated with warfarin use in older patients with heart failure and atrial fibrillation and a cardiovascular implantable electronic device: Findings from the ADHERE registry linked to medicare claims
Background: Warfarin use and associated outcomes in patients with heart failure and atrial fibrillation and a cardiovascular implantable electronic device have not been described previously.
Completion of guideline-recommended initial evaluation of atrial fibrillation
Background: Guidelines recommend evaluation of cardiac function, valvular and ischemic heart disease, and thyroid, kidney, and liver function on initial diagnosis of atrial fibrillation (AF).
Serious mental illness and risk of new HIV/AIDS diagnoses: An analysis of medicaid beneficiaries in eight states
Objective: A longitudinal analysis was used to explore the relationship between diagnosis of serious mental illness and subsequent new diagnoses of HIV. Methods: Logistic regression was used to predict HIV/AIDS diagnoses in 2002-2004 among Medicaid beneficiaries in eight states (N=6,417,676) who were without HIV in 2001.
Effect modification by sex and baseline CD4+ cell count among adults receiving combination antiretroviral therapy in botswana: Results from a clinical trial
The Tshepo study was the first clinical trial to evaluate outcomes of adults receiving nevirapine (NVP)-based versus efavirenz (EFV)-based combination antiretroviral therapy (cART) in Botswana. This was a 3 year study (n=650) comparing the efficacy and tolerability of various first-line cART regimens, stratified by baseline CD4+: <200 (low) vs. 201-350 (high).
Sexual and reproductive health needs of HIV-positive women in Botswana – A study of health care worker’s views
Botswana’s HIV prevalence is one of the highest in the world at 31.8% in the 15-49 years antenatal population. Being HIV-positive for a woman presents unique challenges with regard to sexuality, child bearing, and partner relations.