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https://www.readbyqxmd.com/read/29345540/cost-effectiveness-analysis-of-asymptomatic-peripheral-artery-disease-screening-with-the-abi-test
#1
Nathan K Itoga, Hataka R Minami, Meenadachi Chelvakumar, Keon Pearson, Matthew M Mell, Eran Bendavid, Douglas K Owens
Screening for asymptomatic peripheral artery disease (aPAD) with the ankle-brachial index (ABI) test is hypothesized to reduce disease progression and cardiovascular (CV) events by identifying individuals who may benefit from early initiation of medical therapy. Using a Markov model, we evaluated the cost effectiveness of initiating medical therapy (e.g. statin and ACE-inhibitor) after a positive ankle-brachial index (ABI) screen in 65-year-old patients. We modeled progression to symptomatic PAD (sPAD) and CV events with and without ABI screening, evaluating differences in costs and quality-adjusted life years (QALYs)...
January 1, 2018: Vascular Medicine
https://www.readbyqxmd.com/read/29318439/mind-the-gap-mismatches-between-clinicians-and-patients-in-heart-failure-medication-management
#2
Ken Lee Chin, Marina Skiba, Christopher M Reid, Andrew Tonkin, Ingrid Hopper, Justin A Mariani, Danny Liew
PURPOSE: Previous studies on the 'treatment gap' in patients with heart failure (HF) have focused either on prescribing or patients' adherence to prescribed treatment. This study sought to determine whether or not recent initiatives to close the gap have also minimised any mismatches between physicians' expectation of their patients' medications, medications in the patients' possession and their actual medication use. METHODS: A cross-sectional observational survey was conducted from December 2015 to June 2016 in The Alfred Hospital HF clinic in Melbourne, Australia...
January 9, 2018: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/29240566/a-practical-clinical-approach-to-utilize-cardiopulmonary-exercise-testing-in-the-evaluation-and-management-of-coronary-artery-disease-a-primer-for-cardiologists
#3
Sundeep Chaudhry, Ross Arena, Deepak L Bhatt, Subodh Verma, Naresh Kumar
PURPOSE OF REVIEW: There is growing clinical interest for the use of cardiopulmonary exercise testing (CPET) to evaluate patients with or suspected coronary artery disease (CAD). With mounting evidence, this concise review with relevant teaching cases helps to illustrate how to integrate CPET data into real world patient care. RECENT FINDINGS: CPET provides a novel and purely physiological basis to identify cardiac dysfunction in symptomatic patients with both obstructive-CAD and nonobstructive-CAD (NO-CAD)...
December 13, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29226894/identifying-undiagnosed-or-undertreated-patients-with-familial-hypercholesterolemia-from-the-laboratory-records-of-a-tertiary-medical-center
#4
Cem Haymana, Hamza Berlik, Yalçın Güneş, Orhan Enes Tunçez, Cihat Aytekin, Zafer Tapıkara, Hüseyin Güzel, Özlem Öztürk, Cem Barçın, Taner Özgürtaş, Ömer Azal, Alper Sönmez
OBJECTIVE: Familial hypercholesterolemia (FH) is a life-threatening genetic disease associated with elevated low-density lipoprotein cholesterol (LDL-C) and premature coronary heart disease that is undiagnosed and undertreated around the world. This study aimed to examine the demographic characteristics, awareness, and treatment adherence of undiagnosed or undertreated FH patients based on laboratory records. METHODS: In a 16-month retrospective survey using laboratory records, patients with elevated LDL-C (>250 mg/dL) were identified (n=395)...
December 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29226893/assessment-of-factors-related-to-statin-non-adherence-in-patients-with-established-coronary-artery-disease-a-single-center-observational-study
#5
Tuba Özdemir, İrfan Şahin, İlhan İlker Avcı, Barış Güngör, Eser Durmaz, Sevil Tuğrul, Mert İlker Hayıroğlu, Serdar Kahyaoğlu, Orkhan Karımov, Ertuğrul Okuyan
OBJECTIVE: Lifelong statin treatment is recommended in patients with cardiovascular diseases, but drug adherence is a significant problem. The aim of this study was to investigate factors related to statin discontinuation in high-risk patients with coronary artery disease (CAD) diagnosed by coronary angiography. METHODS: A total of 300 consecutive patients who were followed-up with a diagnosis of CAD were recruited. Patients were categorized as statin adherent or statin non-adherent (patients interrupting statin therapy >30 days)...
December 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29223433/contemporary-rates-and-correlates-of-statin-use-and-adherence-in-nondiabetic-adults-with-cardiovascular-risk-factors-the-kp-champ-study
#6
MULTICENTER STUDY
Alan S Go, Dongjie Fan, Sue Hee Sung, Alda I Inveiss, Victoria Romo-LeTourneau, Usha G Mallya, Susan Boklage, Joan C Lo
BACKGROUND: Statin therapy is highly efficacious in the prevention of fatal and nonfatal atherosclerotic events in persons at increased cardiovascular risk. However, its long-term effectiveness in practice depends on a high level of medication adherence by patients. METHODS: We identified nondiabetic adults with cardiovascular risk factors between 2008 and 2010 within a large integrated health care delivery system in Northern California. Through 2013, we examined the use and adherence of newly initiated statin therapy based on data from dispensed prescriptions from outpatient pharmacy databases...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29203418/electronic-medical-records-can-be-used-to-emulate-target-trials-of-sustained-treatment-strategies
#7
Goodarz Danaei, Luis Alberto García Rodríguez, Oscar Fernández Cantero, Roger W Logan, Miguel A Hernán
OBJECTIVE: To emulate three target trials: single treatment versus no treatment, joint treatment versus no treatment, and head-to-head comparison of two treatments. We explain how to estimate the observational analogs of intention-to-treat and per-protocol effects, using hazard ratios and survival curves. For per-protocol effects, we describe two methods for adherence adjustment via inverse-probability weighting. STUDY DESIGN AND SETTING: Prospective observational study using electronic medical records of individuals aged 55-84 with coronary heart disease from >500 practices in the United Kingdom between 2000-2010...
December 1, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/29203408/medication-non-adherence-and-uncertainty-information-seeking-and-processing-in-the-danish-lifestat-survey
#8
Margit Kriegbaum, Sofie Rosenlund Lau
BACKGROUND: Statins are widely prescribed to lower cardiovascular morbidity and mortality. However, statin non-adherence is very high. PURPOSE: The aim of this paper was to investigate reasons for stopping statin treatment in the general population and to study how aspects of information-seeking and processing is associated with statin non-adherence. METHODS: This study used a population survey on 3050 Danish residents aged 45-65 years. Reasons for statin discontinuation was studied among those who were previous statin users...
September 23, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29194590/effectiveness-of-statins-as-primary-prevention-in-people-with-different-cardiovascular-risk-a-population-based-cohort-study
#9
Maria Garcia-Gil, Marc Comas-Cufí, Jordi Blanch, Ruth Martí, Anna Ponjoan, Lia Alves-Cabratosa, Irene Petersen, Jaume Marrugat, Roberto Elosua, María Grau, Rafel Ramos
To analyze statin effectiveness in a general population with differing levels of coronary heart disease (CHD) risk. Patients (35-74 years) without previous cardiovascular disease were included and stratified according to 10-year CHD risk (<5%, ≥5-7.4%, ≥7.5-9.9%, and ≥10-19.9%). New users were categorized according to their medical possession ratio (MPR). Main outcome was ASCVD (myocardial infarction and ischemic stroke). In adherent patients (MPR ≥70%), statin treatment decreased ASCVD risk across the range of coronary risk (from 16% to 30%)...
December 1, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29168689/in-hospital-prescriptions-of-secondary-prevention-medications-for-post-acute-coronary-syndrome-patients-in-south-korea%C3%A2
#10
Han-Bin Kang, Minwook Choi, Sang Gyeong Yoon, Young Seuk Cho, Nam Kyung Je
BACKGROUND: Optimal medical therapy and the management of cardiac risk factors are crucial for the secondary prevention of acute coronary syndrome (ACS). However, there have been reports on the underutilization of secondary-prevention medications for ACS. This study aimed to investigate adherence of in-hospital prescriptions to clinical practice guidelines for the secondary prevention of ACS using real-world data. MATERIALS AND METHODS: We collected information on ACS patients from national insurance claims data...
January 2018: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29164916/age-and-gender-differences-in-medical-adherence-after-myocardial-infarction-women-do-not-receive-optimal-treatment-the-netherlands-claims-database
#11
Daniëlle C Eindhoven, Alexander D Hilt, Thomas C Zwaan, Martin J Schalij, C Jan Willem Borleffs
Background Following myocardial infarction, medication is, besides lifestyle interventions, the cornerstone treatment to improve survival and minimize the occurrence of new cardiovascular events. Still, data on nationwide medication adherence are scarce. This study assesses medical adherence during one year following myocardial infarction, stratifying per type of infarct, age and gender. Design Retrospective cohort study. Methods In The Netherlands, all inhabitants are by law obliged to have health insurance and all claims data are centrally registered...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29155848/an-electronic-health-record-based-model-predicts-statin-adherence-ldl-cholesterol-and-cardiovascular-disease-in-the-united-states-military-health-system
#12
Joseph E Lucas, Taylor C Bazemore, Celan Alo, Patrick B Monahan, Deepak Voora
HMG-CoA reductase inhibitors (or "statins") are important and commonly used medications to lower cholesterol and prevent cardiovascular disease. Nearly half of patients stop taking statin medications one year after they are prescribed leading to higher cholesterol, increased cardiovascular risk, and costs due to excess hospitalizations. Identifying which patients are at highest risk for not adhering to long-term statin therapy is an important step towards individualizing interventions to improve adherence. Electronic health records (EHR) are an increasingly common source of data that are challenging to analyze but have potential for generating more accurate predictions of disease risk...
2017: PloS One
https://www.readbyqxmd.com/read/29144162/association-between-metformin-adherence-and-all-cause-mortality-among-new-users-of-metformin-a-nested-case-control-study
#13
Patrice Simard, Nancy Presse, Louise Roy, Marc Dorais, Brian White-Guay, Agnès Räkel, Sylvie Perreault
BACKGROUND: Metformin presents better survival rates than other oral antidiabetics in the treatment of type 2 diabetes. However, these benefits may be dampened by inadequate treatment adherence. OBJECTIVE: We aimed to investigate the relationship between adherence level to metformin therapy and all-cause mortality over 10 years in incident metformin users. METHODS: A nested case-control study was conducted using a large cohort of beneficiaries of the Quebec public drug insurance plan, aged 45 to 85 years, who initiated metformin between 2000 and 2009...
November 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29118227/nonadherence-to-statins-and-antihypertensives-and-hospitalizations-among-elderly-medicare-beneficiaries-with-incident-cancer
#14
Ishveen Chopra, Nilanjana Dwibedi, Malcolm D Mattes, Xi Tan, Patricia Findley, Usha Sambamoorthi
Background: Incident cancer diagnosis may increase the risk of coronary artery disease (CAD)-related hospitalizations, especially in older individuals. Adherence to statins and/or angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin II receptor blockers (ARBs)/β-blockers reduces CAD-related hospitalizations. This study examined the relationship between medication adherence and CAD-related hospitalizations immediately following cancer diagnosis. Patients and Methods: A retrospective observational longitudinal study was conducted using SEER-Medicare data...
November 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29116618/treatment-of-stable-angina-with-a-new-fixed-dose-combination-of-ivabradine-and-metoprolol-effectiveness-and-tolerability-in-routine-clinical-practice
#15
Dimitar Divchev, Georg Stöckl
INTRODUCTION: In this prospective, multicenter, observational cohort study, the effectiveness and tolerability of the first fixed-dose combination (FDC) formulation of the selective heart rate reducing agent ivabradine and the beta-blocker metoprolol was evaluated in stable angina pectoris (AP) patients in a clinical practice setting. METHODS: Stable AP outpatients received a FDC of ivabradine and metoprolol (b.i.d.) for 4 months, in addition to cardiovascular standard therapy...
December 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/29076037/the-adherence-rate-threshold-is-drug-specific
#16
Melissa E Stauffer, Paul Hutson, Anna S Kaufman, Alan Morrison
INTRODUCTION: Patient adherence to a medication regimen is usually expressed as an adherence rate, defined as the proportion of prescribed doses actually taken. An adherence rate threshold, above which the therapeutic effect is maintained, is typically assigned an arbitrary value, commonly 0.8. OBJECTIVE: Here, we determined the value of the adherence rate threshold objectively in different drugs of the same class, using statins as an example. METHODS: We used pharmacokinetic/pharmacodynamic (PK/PD) modeling to predict serum levels of low-density lipoprotein cholesterol (LDL-C) in patients taking simvastatin 20 mg or atorvastatin 5 mg once daily for 30 days...
December 2017: Drugs in R&D
https://www.readbyqxmd.com/read/29074093/a-new-hope-lessons-from-heart-outcomes-prevention-evaluation-3
#17
REVIEW
Travis M Howard, Aakash A Bavishi, Neil J Stone
Lifestyle modification is the cornerstone of preventing atherosclerotic cardiovascular disease. When this is not sufficient in reducing risk, statin therapy is first line. Heart Outcomes Prevention Evaluation (HOPE-3) was a randomized controlled trial of rosuvastatin versus placebo, which demonstrated a significant net benefit in a lower-risk population without known atherosclerotic cardiovascular disease. There were many novel characteristics about this trial that should not be overlooked. It contained a diverse population and was the first trial to base inclusion solely on easily ascertainable metabolic risk factors...
October 23, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29039693/variation-in-adherence-to-medications-across-the-healthcare-system-in-two-comparative-effectiveness-research-cohorts
#18
Jessica M Franklin, Macarius M Donneyong, Rishi J Desai, Leona Markson, Cynthia J Girman, Caroline McKay, Mehul D Patel, Panagiotis Mavros, Sebastian Schneeweiss
AIM: To assess heterogeneity in adherence to medications in two example comparative effectiveness research studies. PATIENTS & METHODS: We analyzed data from commercially insured patients initiating a statin or anticoagulant during 2005-2012. We calculated the cross-validated R(2) from a series of hierarchical linear models to assess variation in 1-year adherence. RESULTS: There was less heterogeneity in adherence in the statin cohort compared with the anticoagulant cohort, where patient characteristics explained 7...
October 17, 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/29020356/a-common-missense-variant-of-lilrb5-is-associated-with-statin-intolerance-and-myalgia
#19
Moneeza K Siddiqui, Cyrielle Maroteau, Abirami Veluchamy, Aleksi Tornio, Roger Tavendale, Fiona Carr, Ngu-Uma Abelega, Dan Carr, Katyrzyna Bloch, Par Hallberg, Qun-Ying Yue, Ewan R Pearson, Helen M Colhoun, Andrew D Morris, Eleanor Dow, Jacob George, Munir Pirmohamed, Paul M Ridker, Alex S F Doney, Ana Alfirevic, Mia Wadelius, Anke-Hilse Maitland-van der Zee, Daniel I Chasman, Colin N A Palmer
Aims: A genetic variant in LILRB5 (leukocyte immunoglobulin-like receptor subfamily-B) (rs12975366: T > C: Asp247Gly) has been reported to be associated with lower creatine phosphokinase (CK) and lactate dehydrogenase (LDH) levels. Both biomarkers are released from injured muscle tissue, making this variant a potential candidate for susceptibility to muscle-related symptoms. We examined the association of this variant with statin intolerance ascertained from electronic medical records in the GoDARTS study...
August 29, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28993930/in-search-of-a-standard-when-analyzing-medication-adherence-in-patients-with-heart-failure-using-claims-data-a-systematic-review
#20
REVIEW
Katrin Krueger, Nina Griese-Mammen, Ingrid Schubert, Marita Kieble, Lea Botermann, Ulrich Laufs, Charlotte Kloft, Martin Schulz
To determine and address medication non-adherence is important and may improve patient outcomes. Our aim was to perform a systematic review on the operationalization of adherence measures in patients with heart failure using claims data. We searched the MEDLINE, EMBASE, and Cochrane databases. A quality check of the full-text articles was performed using the Quality in Prognosis Studies tool. We included 28 studies. Eleven studies used the medication possession ratio, 15 the proportion of days covered, and six studies used own methods to calculate medication adherence...
October 9, 2017: Heart Failure Reviews
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