Medication Usage Patterns Research Articles

Medical service use and usual care of common shoulder disorders in Korea: a cross-sectional study using the Health Insurance Review and Assessment Service National Patient Sample

ObjectivesThis study examined National Health Insurance claims data to investigate the epidemiology of shoulder disorders in Korea. Detailed information on medical services and related costs was assessed by major shoulder...

Patterns of medical management of overactive bladder (OAB) and benign prostatic hyperplasia (BPH) in the United States

Overactive bladder (OAB) and benign prostatic hyperplasia (BPH) are highly prevalent conditions that place a large burden on the United States (US) health care system. We sought to analyze patterns of prescription medication usage for incident OAB in men and women, and for incident BPH in men using US health insurance claims data. This study used Truven Health MarketScan® Commercial and Medicare Supplemental Research databases. The data were pooled from diverse points of care. BPH subjects included men age 18+ with the first and last two diagnoses of BPH ≥30 days apart and no BPH diagnosis for 1 year prior. OAB subjects included men and women age 18+, who were diagnosed similarly with incident OAB. The type of medication, medication continuation (persistence), and switching to a different medication were analyzed through September 30, 2013. Medication persistence was much higher overall for BPH than OAB (56% vs 34%, respectively, P < 0.0001), and was highest among men with BPH age 65+ (62%). Patients age 18-64 were less likely to continue medication than older adults (age 65+) for both BPH and OAB. A 9.4% of patients in the OAB cohort and 6.9% of men with BPH switched from one medication to another. Persistence was higher with BPH than OAB medications overall, whereas switching rates were higher in the OAB group. The lower persistence of OAB medication may be due to less efficacy or tolerability. The possibility of under treatment of OAB also warrants future investigations.

MP76-16 PATTERNS OF MEDICAL MANAGEMENT OF OVERACTIVE BLADDER (OAB) AND BENIGN PROSTATIC HYPERPLASIA (BPH) IN THE US: WHO DOES BETTER?

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life and Shared Decision Making IV1 Apr 2017MP76-16 PATTERNS OF MEDICAL MANAGEMENT OF OVERACTIVE BLADDER (OAB) AND BENIGN PROSTATIC HYPERPLASIA (BPH) IN THE US: WHO DOES BETTER? Jennifer Anger, Howard Goldman, Xuemei Luo, Martin Carlsson, Douglass Chapman, Kelly Zou, Fady Ntanios, David Russell, Canan Esinduy, and J. Quentin Clemens Jennifer AngerJennifer Anger More articles by this author , Howard GoldmanHoward Goldman More articles by this author , Xuemei LuoXuemei Luo More articles by this author , Martin CarlssonMartin Carlsson More articles by this author , Douglass ChapmanDouglass Chapman More articles by this author , Kelly ZouKelly Zou More articles by this author , Fady NtaniosFady Ntanios More articles by this author , David RussellDavid Russell More articles by this author , Canan EsinduyCanan Esinduy More articles by this author , and J. Quentin ClemensJ. Quentin Clemens More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2144AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES BPH and OAB are highly prevalent conditions that place a large burden on the US health care system. Medical management is the mainstay of therapy for both conditions, but few datasets are available that analyze patterns of medication usage and long-term persistence. This study analyzes patterns of prescription medication usage for incident BPH in men and incident OAB in men and women using US observational data. METHODS Truven Health MarketScan® Commercial and Medicare Supplemental Research databases include de-identified medical claims and prescription drug claims for individuals in the US with employer-sponsored health insurance, as well as individuals with Medicare supplemental coverage. The data are pooled from diverse points of care, including large employers, managed care organizations, hospitals, and public organizations, thus providing greater generalizability than single payer databases. Men age 18+ had incident BPH with 2 diagnoses of BPH =30 days apart and no BPH diagnosis for 1 year prior, based on ICD-9 codes for BPH, bladder neck obstruction, urinary retention, and incomplete bladder emptying. Men and women age 18+ were diagnosed similarly with incident OAB, based on ICD-9 codes for OAB symptoms (urinary frequency, urgency, nocturia, urge incontinence). Other criteria included continuous enrollment for 1 year before and 6 months after the first diagnosis date. Medication continuation (persistence), switching, and discontinuation were analyzed through September 30, 2013. RESULTS 31,701 women and 7,208 men were prescribed OAB medication; 69,079 men were prescribed medication for BPH (Table 1). Medication persistence was much higher overall for BPH than OAB (56% vs 34%, respectively), and was highest among men with BPH age 65+ (62%). Patients age 18-64 were less likely to continue medication than older adults (age 65+) for both BPH and OAB. CONCLUSIONS Persistence was higher with BPH than OAB medications overall, likely reflecting a combination of better efficacy and tolerability of BPH medications. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1019 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Jennifer Anger More articles by this author Howard Goldman More articles by this author Xuemei Luo More articles by this author Martin Carlsson More articles by this author Douglass Chapman More articles by this author Kelly Zou More articles by this author Fady Ntanios More articles by this author David Russell More articles by this author Canan Esinduy More articles by this author J. Quentin Clemens More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Qualitative Analysis of Medical Usage Patterns of Medical Aid Patients

Qualitative Analysis of Medical Usage Patterns of Medical Aid Patients

PDB8 - Iatrogenic Hypoglycaemia in the Elderly: An Analysis of Diabetic Medication Usage Patterns According to Age

We performed a retrospective data analysis to examine the use of medications that can cause hypoglycaemia in elderly diabetes mellitus patients in Malaysia. We utilised data from the National Diabetes Registry from 2012 containing data from diabetes patients followed up in Malaysian public sector primary care clinics. Medications analysed were anti-diabetic (metformin, sulphonylurea, acarbose, insulin) and anti-hypertensive drugs classes (ACE-inhibitors, beta-blockers) which were widely used in the study population. Descriptive and univariate analyses were performed to examine the use of these medications across various age groups. A total of 130,246 patients with T2DM were included in the study. The patients were divided into 4 age groups, with 8.4% under 45 years old, 58.3% aged between 45–64 years, 29.8% between 65-79 years old and 3.5% over 80 years of age. The mean HbA1c of patients in the <45 years age group was the highest at 8.68% and lowest in the ≥80 years age group at 7.11%. There were significant reductions in the use of metformin (from 83.97% to 68.69% of patients) and insulin (24.70% to 12.03%) with age (all P<0.001). However, sulphonylurea use was similar cross all age groups (52.55% to 57.44%, P=0.500) while use of acarbose was generally higher in older patients (3.12% to 3.94%, P<0.001). In the subset of diabetics with hypertension, use of ACE inhibitors declined with age (64.43% to 49.95%, P<0.001) while use of beta blockers increased with age (20.11% to 35.56%, P<0.001). Despite limitations of our study especially related to reasons for prescribing different drugs, we note that a large proportion of older patients are still prescribed with medications that potentially cause hypoglycaemia, in particular, sulphonylureas and beta-blockers. This finding is to remind doctors to proceed with caution in treating the elderly when treating the elderly with certain medications.

Medication usage, treatment intensification, and medical cost in patients with type 2 diabetes: a retrospective database study

ObjectiveThe goal of this study was to describe medication usage patterns in patients with type 2 diabetes mellitus (T2DM) initiating treatment with non-insulin antidiabetic drugs (NIADs), basal insulin, or prandial/mixed...

Medication use patterns, health care resource utilization, and economic burden for patients with major depressive disorder in Beijing, People's Republic of China.

ObjectiveThe objective of the study was to investigate medication usage patterns, health care resource utilization, and direct medical costs of patients with major depressive disorder (MDD) in Beijing, People’s Republic of China.MethodsData were extracted from a random sample of the Beijing Urban Employee Basic Medical Insurance database. Patients aged ≥18 years, with ≥1 primary diagnosis of MDD and 12-month continuous enrollment after their first observed MDD diagnosis between 2012 and 2013 were identified. Those with a diagnosis of schizophrenia, bipolar disorder, or cancer during the analysis period were excluded.ResultsIn total 8,484 patients, with a mean age of 57.2 years, were included and 63% were female. The top three commonly observed comorbidities were hypertension (70.9%), anxiety disorder (68.6%), and coronary heart disease (65.1%). Furthermore, 71.4% of patients were treated with antidepressant medications, including 60.5% of patients treated with selective serotonin reuptake inhibitors, followed by noradrenergic and specific serotonergic antidepressants (9.0%) and serotonin–norepinephrine reuptake inhibitors (8.3%). The proportions of patients who discontinued their initial antidepressant within the first and second months after the index date were 45.4% and 77.0%, respectively. Concomitant medications were prescribed for 76.8% of patients. Only 0.42% of patients experienced ≥1 MDD-related hospitalization(s) during the 1-year follow-up, and the average annual number of hospitalization was 1.2 for those hospitalized. The mean length of stay was 33.4 days per hospitalization. All patients had ≥1 MDD-related outpatient visit(s). The mean annual number of outpatient visits per patient was 3.1. The mean annual direct medical costs per patient with MDD was RMB ¥1,694.1 (48.5% for antidepressant medications), and that for hospitalized patients was RMB ¥21,291.0 (15.0% for antidepressant medications).ConclusionIn Beijing, the majority of patients with MDD were treated in the outpatient setting only and they received antidepressants. Selective serotonin reuptake inhibitors were the most commonly used antidepressants. However, the duration to antidepressant medication was short, and persistence was low. The economic burden of MDD-related hospitalization was considerable.

Ankylosing Spondylitis Treatment and Follow-Up Costs in Colombia

to estimate the cost of Ankylosing spondylitis (AS) in Colombia. Background: AS is part of a group of pathologies of the spine called Spondylo-arthropathies, characterized by low frequency but with a severe disability, and high requirements of medical resources and costs A structured survey was answered by seven rheumatologists in the country, in order to determine patterns of medication usage, management of adverse events, monitoring practice and follow-up of patients with AS in a year. Valuation of health resources and procedures were based on national standard tariffs (ISS 2001 + 30% and SOAT 2014). Medication prices were obtained from SISMED and price regulation official documents. Costs are reported in local currency (COP) Average annual cost of NSAIDs COP 105,509 pesos (range: COP 5,219.5 to 151,986). Second line DMARDs cost range between COP 3,104.33 and 4,307,000. Biologic antiTNF annual cost fluctuates towards COP 28.661.464 and 30.264.000. Monitoring and follow up costs range between COP 3.741.018 and 6.445.367. High uncertainty in expected adverse events costs between COP 6.558 to 3.382.456 per year. The AS is a disease represents a high economic burden for health system in Colombia.

Actions following adverse drug events - how do these influence uptake and utilisation of newer and/or similar medications?

BackgroundOver the last decade, actions following some adverse drug events received major publicity. This study investigated changes in usage patterns of medications in Australia following two examples - rofecoxib market withdrawal (2004) and warnings about jaw necrosis following bisphosphonates (2007).MethodsDispensing data for COX-2 inhibitors (2000–2008) and anti-osteoporosis medications (2003–2012) were obtained from the Australian Pharmaceutical Benefits Scheme database. For bisphosphonates, data on Australian marketing expenditures were purchased from CegedimR.ResultsFor COX-2 inhibitors, celecoxib dispensing halved after rofecoxib withdrawal, but meloxicam dispensing increased by 60 %. When lumiracoxib was introduced (2006) there was uptake of prescribing at a faster rate than meloxicam in 2002, its first year of use. For bisphosphonates, alendronate had highest use at the time of the warnings (8.3 DDD/1000/day), dropping to 4.9 DDD/1000/day by 2012. In contrast, risedronate use rose 2007–2012 from 4.1 to 4.9 DDD/1000/day. There was 49 % increase in reported annual expenditure on detailing for risedronate from 2007 to 2008 (to AUD$7.3 million) and only 29 % increase for alendronate (to AUD$3.1 million).ConclusionsThe rapid uptake of prescribing of lumiracoxib and increased use of meloxicam flagged a concern, especially after rofecoxib withdrawal due to safety issues. Bisphosphonates are useful drugs, however the dramatic rise in expenditure on detailing, followed by a rise in utilisation of risedronate could suggest that adverse publicity triggered a marketing response. These examples highlight the importance of tracking utilisation of medication classes in real time, using different data as needed, to ensure that due caution is exercised (and quick intervention provided if needed) for medications in the same class.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-1165-9) contains supplementary material, which is available to authorized users.

Differences in ADHD medication usage patterns in children and adolescents from different cultural backgrounds in the Netherlands.

Differences in incidence and prevalence of ADHD medication use between ethnic groups have been reported. Goal of this study was to determine whether there are also differences in usage patterns of ADHD medication among native Dutch children and adolescents and those with a Moroccan, Turkish and Surinam cultural background in the Netherlands between 1999 and 2010. In a cohort of ADHD patients<19years (N=817) incident use and discontinuation of ADHD medication were measured for ethnicity and adjusted for age, gender and socio-economic status. A significant higher proportion of ADHD-diagnosed patients from Moroccan (32%) and Turkish (42%) cultural background never used ADHD medication compared to Dutch natives (21%). One-fifth of native Dutch and Turkish patients already used ADHD medication before the ADHD diagnosis date. Discontinuation of ADHD medication within 5years was significantly higher in Moroccan [HR 2.4 (95% CI 1.8-3.1)] and Turkish [HR 1.7 (95% CI 1.1-2.6)] patients. A sensitivity analysis with a zip code-matched comparison between Dutch natives and non-natives showed similar results, suggesting this effect is probably not explained by socio-economic status (SES). Differences are found in prescribing and use of ADHD medication between patients with a different cultural background. Native Dutch and Turkish patients start more frequently with ADHD medication before the ADHD diagnose date, which can be an indication of differences in either referral patterns and/or access to care. A higher percentage of patients with a Moroccan and Turkish cultural background never start using ADHD medication at all and discontinuation rate is higher compared to Dutch natives and Surinamese.

A Study of the Association Between Patterns of Eye Drop Prescription and Medication Usage in Glaucoma Subjects

To investigate the association between patterns of eye drop prescription and medication usage in patients with glaucoma. Sixty-seven Japanese patients with glaucoma who were prescribed topical antiglaucoma medications including a prostaglandin analogue bilaterally for >6 months at Nayoro City General Hospital, Nayoro, Japan, were included in the study. A self-administered, 5-item patient questionnaire was administered to determine how patients routinely use medications, including the method of eye drop administration, number of eye drops per instillation, accuracy of eye drop placement, weekly frequency of eye drop application, and their awareness of local side effects. The number of prostaglandin analogue bottles prescribed monthly was compared in each factor. The mean patient age was 74.4±10.0 years (range, 52 to 95 y; 39 women, 28 men). The mean duration of glaucoma treatment was 4.2±3.2 years (range, 0.7 to 10.6 y). Patients who placed the eye drops outside the eye were prescribed significantly more bottles monthly (P=0.008). The other factors had no significant effect on the number of bottles prescribed monthly. Patients with glaucoma who used eye drops incorrectly were routinely prescribed additional bottles of eye drops. Ophthalmologists should determine whether patients who request an unusual number of eye drops are using the eye drops correctly.

ANTI-HYPERGLYCEMIC MEDICATION USE AMONG MEDICARE BENEFICIARIES WITH HEART FAILURE, DIABETES, AND CHRONIC KIDNEY DISEASE

Diabetes (DM) and chronic kidney disease (CKD) are common co-morbidities in patients with heart failure (HF). However, there is uncertainty on optimal DM management with these co-morbidities, and usage patterns of anti-hyperglycemic medications (AHM) among these complex patients are poorly

Long-Term Clinical Outcome of Patients Using Risperidone Long-Acting Injectable: The Romanian e-STAR Database

The objectives of e-STAR Romania (NCT00283517) were to collect clinical outcome data of Romania schizophrenia or schizo-affective disorder patients; prospectively to assess the reasons of treatment initiation, medication usage patterns; to document (long-term) clinical efficacy; and to collect safety data, as well as recording 2-year corresponding retrospective data. In total, 378 eligible subjects were enrolled who were initiated either on risperidone long-acting injectable (RLAI) (290) or on an oral antipsychotic (OA) (88) at baseline as required by the local Summary of the Product Characteristics. Data were collected from per patient both retrospectively and prospectively over a 24-month period at 3-month intervals after starting treatment. The results indicated that subjects suffering from schizophrenia or schizo-affective disorder initiated on RLAI were less likely to be hospitalized within the first 24 months after the initiation of treatment. Moreover, subjects treated with RLAI experienced significant improvements in their illness severity and functioning. Discontinuation rates for RLAI were low and doses were stable throughout the 24 months following the initiation of treatment. In addition, the necessity for supplementary concomitant medication was reduced. Adverse events were reported in 20.3% (RLAI) and 11.4% (OA) of the subjects. In general, patients initiated on RLAI and OA at baseline both clinically improved on all assessed parameters but a larger improvement was observed for patients on RLAI. Incidences of reported AEs during the use of RLAI in a naturalistic setting are comparable with those described in clinical studies; however, the incidence of extrapyramidal signs and weight gain was lower than expected.

Assessing The Medication Use Among Diabetic Patients With Comorbid Diseases.

Type 2 Diabetes is on the rise in many Asian countries with growing economic prosperity. Treatment patterns of diabetic patients in South East Asia have rarely been studied using administrative data. Our objective was to understand medication use patterns among Malaysian patients with diabetes with comorbidities in the primary health care setting. This may be useful for understanding treatment strategies in subgroups of patients with diabetes who tend to pose more complex challenges in clinical decision-making. Data was obtained from diabetic patients who were audited in the NDR in 2012. Descriptive analysis was used to describe medication usage for patients with various comorbidities. Medications of interest were antiplatelet medications, lipid-lowering agents, anti-hypertensive and various classes of anti-diabetic medications including insulin. A total of 130,270 patients were identified with comorbidities. Mean age of patients was 59.8 years old and 60.2% were female. A majority of patients were hypertensive (70.3%), more than half were dyslipidemic (55.1%). Other comorbidities such as retinopathy, ischemic heart disease (IHD), cerebrovascular disease, nephropathy, diabetic foot ulcer, amputation, hypertension and dyslipidemia were recorded among less than 10% of patients. Among non-diabetes medications, statins was the most commonly used ranging from 64.6% to 86.3% for various comorbidities. This was followed by ACE-inhibitors and aspirin. Among anti-diabetic medications, metformin was the most commonly prescribed followed by sulfonylureas and insulins. The registry data was able to shed light on patterns of medication usage among diabetic patients with comorbidities. Perhaps in the future, this data can be used to evaluate long-term outcomes among patients on various treatment plans and finally to inform more evidence-based clinical management strategies relating to medication use.

Medication Usage Pattern, Health Resource Utilization and Economic Burden for Patients with Mdd in Beijing, China.

Medication Usage Pattern, Health Resource Utilization and Economic Burden for Patients with Mdd in Beijing, China.

Adverse Drug Event Detection in Pediatric Oncology and Hematology Patients: Using Medication Triggers to Identify Patient Harm in a Specialized Pediatric Patient Population

To investigate the use of a trigger tool for the detection of adverse drug events (ADE) in a pediatric hospital specializing in oncology, hematology, and other catastrophic diseases. A medication-based trigger tool package analyzed electronic health records from February 2009 to February 2013. Chart review determined whether an ADE precipitated the trigger. Severity was assigned to ADEs, and preventability was assessed. Preventable ADEs were compared with the hospital's electronic voluntary event reporting system to identify whether these ADEs had been previously identified. The positive predictive values (PPVs) of the entire trigger tool and individual triggers were calculated to assess their accuracy to detect ADEs. Trigger occurrences (n = 706) were detected in 390 patients from 6 medication triggers, 33 of which were ADEs (overall PPV = 16%). Hyaluronidase had the greatest PPV (60%). Most ADEs were category E harm (temporary harm) per the National Coordinating Council for Medication Error Reporting and Prevention index. One event was category H harm (intervention to sustain life). Naloxone was associated with the most grade 4 ADEs per the Common Terminology Criteria for Adverse Events v4.03. Twenty-one (64%) ADEs were preventable, 3 of which were submitted via the voluntary reporting system. Most of the medication-based triggers yielded low PPVs. Refining the triggers based on patients' characteristics and medication usage patterns could increase the PPVs and make them more useful for quality improvement. To efficiently detect ADEs, triggers must be revised to reflect specialized pediatric patient populations such as hematology and oncology patients.

Medication usage patterns for headache treatment after mild traumatic brain injury.

To describe patient self-report of headache treatment in the first year following mild traumatic brain injury (TBI). An understanding of appropriate management of symptoms after mild TBI is crucial for improving acute care and long-term outcomes. This is particularly true for post-traumatic headaches as recent studies suggest that headaches after mild TBI are common with multiple phenotypes. In addition, symptoms such as headache after mild TBI are often managed by primary care providers without specialty training, and often in medically underserved areas. Outside of previous opinion papers, few studies have guided the treatment or examined the effectiveness of the interventions for post-traumatic headache. One hundred sixty-seven participants admitted to a level 1 trauma hospital with mild TBI who were prospectively enrolled and reported new or worse headache at 3, 6, or 12 months after injury. Participants were primarily male (75%), white (75%), injured in vehicle crashes (62%), and had completed high school (83%). The majority of headaches met International Classification of Headache Disorders-2nd edition criteria for migraine/probable migraine, followed by tension-type headache. Despite the diverse nature of headaches, more than 70% of those with headache at each time period used acetaminophen or a nonsteroidal anti-inflammatory drug for headache control. Only 8% of those with the migraine/probable migraine phenotype used triptans. Of those individuals who used medication, 26% of those with migraine/probable migraine phenotype and 70% of those with tension headache phenotype endorsed complete relief (vs partial or no relief) because of medication use. The majority of individuals with tension headache reported never taking medication. Headaches after mild TBI are frequent and are not optimally treated. Results suggest that many individuals with mild TBI may be self-treating their headaches by utilizing over-the-counter pain relief medications. These medications, however, are only providing effective treatment for a minority of this population. Further research must be conducted to develop evidence-guided treatment and educate providers.

Reasons for referral, intervention approaches and demographic characteristics of clients with intellectual disability attending adult psychiatric outpatient services in the Kingdom of Bahrain

Relatively little information is available regarding the use of psychiatric services by individuals with intellectual disability (ID) in Arab countries. The current study aimed to identify (1) the reasons for referral; (2) demographic characteristics of individuals referred; (3) previous contact with child psychiatric services; (4) psychiatric diagnoses; (5) level of ID; (6) nature of interventions; and (7) patterns of medication usage in individuals attending a specialist psychiatric service for individuals with an ID in the Kingdom of Bahrain. Case file analysis was used. Files that recorded attendance at the specialist service within a specific calendar year were selected. A total of 537 files were available for review and 79 contained records indicating the individual had been seen within the year. The primary referral reason to adult psychiatric services was the presence of behavioural disturbance. Pharmacological intervention was the dominant treatment choice and no individual was recommended for psychological/behavioural intervention. Psychiatric diagnosis was not recorded in over 90% of cases. Services in the Kingdom of Bahrain for individuals with ID rely exclusively on pharmacological approaches for the treatment of behavioural disorders. Implications for best practice guidelines are discussed.

Medication-Related Problems Identified in Home Medicines Reviews Conducted in an Australian Rural Setting

To analyze the prevalence, nature, and patterns of medication-related problems (MRPs) and to explore relationships between these and the patterns of medication usage and clinical characteristics of the patients for whom Home Medicines Reviews (HMRs) were provided. Retrospective analysis of 100 HMR reports. MRPs were grouped according to class. Analysis of medication usage patterns was undertaken using standard systems for classification of therapeutic actions and dosage intensity. In Australia, accredited pharmacists conduct HMRs through the federally funded HMR program, aiming to detect and prevent or resolve MRPs. This study analyzed HMR reports for a cohort of home-dwelling patients living in a small rural community in South Australia. MRPs were characterized and analyzed by drug class and dosage intensity. 130 MRPs were identified in 73 patients (mean ± standard deviation: 1.30 ± 1.22 per patient). The most common types of problems were an untreated indication for treatment and failure to receive medication (both n = 23), followed by adverse drug events (n = 21), drugdrug interactions, and improper drug selection (n = 19). Cardiovascular, central nervous system, and musculoskeletal agents were the classes most frequently associated with MRPs. Medication-usage patterns were similar to those observed in previous research conducted in urban settings, both in Australia and internationally. The findings lend further support for an expanded role for pharmacists in the primary health care system, suggesting that HMRs and the medication review process can improve medication use and overall patient health outcomes.

FRI0366 Dmard use in the treatment of juvenile idiopathic arthritis: A cross-sectional analysis of the childhood arthritis and rheumatology research alliance (CARRA) registry

BackgroundThere have been fundamental changes in the treatment of juvenile idiopathic arthritis (JIA) over the last decade, including the introduction and widespread use of biologic DMARDs. However, the utilization of...