Medication Purchases Research Articles

Longitudinal analysis of health care costs in patients with childhood onset inherited retinal dystrophies compared to healthy controls

BackgroundWe evaluated health care costs in patients with childhood onset visual impairment caused by inherited retinal dystrophies (IRD).MethodsThe IRD cohort, identified from the Danish Registry of Blind and Partially Sighted Children, was compared to age- and sex-matched controls from the national, Danish population registry. Information on health care expenditures for somatic and psychiatric in- and outpatient services, purchase of prescription medications and paid assistance at home were obtained from national registries for the years 2002–2017.ResultsWe included 412 in the IRD cohort (6,290 person years) and 1656 (25,088 person years) in the control cohort. Average, annual health care expenditures from age 0–48 years of age were €1,488 (SD 4,711) in the IRD cohort and €1,030 (4,639) in the control cohort. The largest difference was for out-patient eye care (13.26 times greater, 95% confidence interval 12.90–13.64). Psychiatric in-patient expenditures were 1.71 times greater (95% CI 1.66–1.76) in the IRD cohort but psychiatric out-patient health care costs were comparable between groups.ConclusionsHealth care costs were approximately 40% greater in the IRD cohort compared to an age- and sex-matched sample from the general Danish population. This is relevant in the current situation with a number of trials aimed at treating IRDs using genetically based therapies. Although eye care expenditures were many times greater, they made up < 10% of the total health care expenditures even in the IRD cohort. The reduced costs related to injuries in the visually impaired cohort was a surprising finding but may reflect a reduced propensity to seek medical care rather than a reduced risk of injuries.

Pre-existing psychological disorders, diabetes, and pancreatic cancer: A population-based study of 38,952 Finns

BackgroundIt remains unclear how pre-existing depression, anxiety, and diabetes of different durations are associated with the risk of pancreatic cancer, its clinical characteristics, treatment modalities, and subsequent survival. MethodsFrom a register-based random sample of Finns residing in Finland at the end of the period 1987–2007, 6492 patients diagnosed with primary pancreatic cancer in 2000–2014, and 32 460 controls matched for birth cohort and sex, were identified. Pre-existing depression, anxiety, and diabetes were ascertained from the records of prescribed medication purchases. Information on pancreatic cancer outcomes was obtained from the Finnish cancer register. Data were analyzed using logistic and Cox regressions. ResultsThe risk of developing pancreatic cancer was found to be associated with long-term anxiety (treatment started 36 + months before the cancer diagnosis) (odds ratio (OR): 1.13, 95% confidence interval (95%CI): 1.04–1.22) and long-term diabetes (OR 1.72, 95%CI 1.55–1.90), as well as with new-onset (treatment started 0–24 months before the cancer diagnosis) depression (OR 1.59, 95%CI 1.34–1.88), anxiety (OR 1.76, 95%CI 1.50–2.07), and diabetes (OR 3.92, 95%CI 3.44–4.48). However, the effects of these new-onset conditions were driven by cases that began treatment within 3 months before the cancer diagnosis (concomitant period). Patients with long-term depression, anxiety and diabetes and those with new-onset anxiety had a higher risk of not receiving standard treatments. Lower survival was found for pancreatic cancer patients with new-onset depression (hazards ratio (HR) 1.38, 95%CI 1.16–1.64). Survival was not associated with pre-existing anxiety or diabetes. ConclusionsThe associations between pancreatic cancer risk and pre-existing depression and anxiety were mostly driven by concomitant effects. Individuals with diabetes, regardless of duration, should be closely monitored for pancreatic cancer. Pancreatic cancer patients with new-onset depression should be targeted to improve their survival.

A Novel Multi-view Bi-clustering method for identifying abnormal Co-occurrence medical visit behaviors.

Abnormal co-occurrence medical visit behavior is a form of medical insurance fraud. Specifically, an organized gang of fraudsters hold multiple medical insurance cards and purchase similar drugs frequently at the same time and the same location in order to siphon off medical insurance funds. Conventional identification methods to identify such behaviors rely mainly on manual auditing, making it difficult to satisfy the needs of identifying the small number of fraudulent behaviors in the large-scale medical data. On the other hand, the existing single-view bi-clustering algorithms only consider the features of the time-location dimension while neglecting the similarities in prescriptions and neglecting the fact that fraudsters may belong to multiple gangs. Therefore, in this paper, we present a multi-view bi-clustering method for identifying abnormal co-occurrence medical visit behavioral patterns, which performs cluster analysis simultaneously on the large-scale, complex and diverse visiting record dimension and prescription dimension to identify bi-clusters with similar time-location features. The proposed method constructs a matrix view of patients and visit records as well as a matrix view of patients and prescriptions, while decomposing multiple data matrices into sparse row and column vectors to obtain a consistent patient population across views. Subsequently the proposed method identifies the corresponding abnormal co-occurrence medical visit behavior and may greatly facilitate the safe operations and the sustainability of medical insurance funds. The experimental results show that our proposed method leads to more efficient and more accurate identifications of abnormal co-occurrence medical visit behavior, demonstrating its high efficiency and effectiveness.

Combined effects of cues influencing patients’ purchasing behavior in online health-care communities: qualitative comparative analysis based on cue utilization theory

BackgroundThe sudden outbreak of COVID-19 in early 2020 pushed the online health-care communities (OHCs) into the public eye in China. However, OHCs is an emerging service model, which still has many problems such as low patient trust and low patient utilization rate. Patients are the users and recipients of web-based medical services, as well as the core of medical services. Thus, based on cue utilization theory, this paper studies combination effect of influencing factors in patients’ purchase of web-based medical services through the qualitative comparative analysis method of fuzzy sets (fsQCA).MethodsThis paper discards statistical methods based on variance theory-based relationships between explanatory and explained variables and uses a construct theory-based fuzzy set qualitative comparative analysis (fsQCA) approach to elucidate such complex relationships of patients' online purchasing behavior. We use a crawler to automatically download information from Haodf.com. This study crawled data in August 2020, involving 1210 physicians.ResultsService price, reputation and service quality are the key factors for patients’ purchasing behavior. Physician’s online reputation, online medical service price, number of published articles, mutual-help group, and appointment registration affect patients' purchasing behavior by means of weighted variation. Only when a high scope of internal attribute-related cue elements and a low scope of external attribute-related cue elements are combined with each other in a specific form, patients will generate purchase behavior.ConclusionThis paper clarifies the complex causes that promote to patients' purchasing behavior of web-based medical services, enriches and develops the relevant theories in the field of consumer purchasing behavior and online health-care communities market research, and has implications for governments, platforms, physicians and patients in the event of web-based medical service purchases.

Distinctive mental health profiles in the working population: A nation-wide study from Finland

Abstract Introduction Studies on mental health inequalities are usually based on limited sets of mental health indicators. Objectives Using a large number of mental health indicators, we explored whether it is possible to identify similar hierarchical rankings regardless of mental health indicators (incl. psychotherapy) among employees representing different socio-demographic statuses, and which groups of employees have the highest mismatch between mental health symptom and treatment. Methods Employees representing different occupational classes and employees from four different areas of Finland were studied and compared. We used national register data to define psychotropic medication (purchases), sickness absence for mood disorders, and the use of psychotherapy between 2017 and 2019 and national survey data from the FinHealth 2017 Study to define the level of psychological symptoms (BDI, GHQ). We assessed the risk of each outcome by population group separately for men and women, and estimated the mismatch between symptoms (BDI/GHQ caseness) and treatment (psychotropic drugs/therapy). Results In all the studied groups, the prevalence of mental health indicators was mostly considerably higher among women than men. The risk of register-based mental health indicators was typically higher among lower non-manual employees. In the case of some mental health indicators, we observed significant interactions between occupation class and region. Some stark mismatches were detected between symptoms and treatment in some populations, whereas at the other end of the spectrum, the correspondence between symptoms and the mobilization of care was rather high. Conclusions Although gender is strongly linked to mental health indicators, occupational class and region influence mental health profiles in the population. There are considerable inequalities between populations in the level of professional care associated with mental health problems.

Association Between Cardiorespiratory Fitness and Incident Purchase of Hypnotic Drugs in Adults: The HUNT Study

ObjectiveTo assess whether cardiorespiratory fitness (CRF) is associated with first purchase of a prescribed hypnotic drug in the adult population. MethodsA total of 34,357 adult participants (53.9% women) with a mean age of 51.5 years (SD 15.6 years) from the third Trøndelag Health Study (HUNT) of 2006 to 2008 were observed until January 1, 2018. Cardiorespiratory fitness was estimated from a validated nonexercise algorithm. Data on first hypnotics prescription were obtained through linkage to the National Norwegian Prescription Database. Cox regression with 95% CIs was used to estimate hazard ratios (HRs). ResultsAfter 304,899 person-years of follow-up, 5791 participants had their first registered purchase of prescribed hypnotics, corresponding to an incidence rate of 1.90 per 100 person-years. Each 1–metabolic equivalent of task increase in CRF was significantly associated with 5% (HR, 0.95; 95% CI, 0.91 to 0.99; P=.02) and 4% (HR, 0.96; 95% CI, 0.92 to 1.00; P=.046) risk reduction for incident use of hypnotics in men and women, respectively. When CRF was categorized into tertiles with lowest CRF as the reference group, reduced risk was 13% (HR, 0.87; 95% CI, 0.79 to 0.96; P=.006) and 15% (HR, 0.85; 95% CI, 0.77 to 0.95; P=.003) for men in the intermediate and highest CRF category, respectively. In women with highest CRF, the reduced risk was 5% (HR, 0.95; 95% CI, 0.87 to 1.03; P=.22). ConclusionCardiorespiratory fitness in adulthood is associated with incident purchase of prescription medication commonly used for sleep problems. These findings suggest that fitness should be considered a target for preventing sleep problems in adults.

Pathways into single motherhood, re-partnering, and trajectories of antidepressant medication purchases

Single motherhood is known to be distressing, and to be associated with poor mental health. However, less is known about the pathways into and out of single motherhood, or about the mental health trajectories of single mothers. We used total population registry data on Finnish women who experienced the life events of separation (616,762), widowhood (43,355), or child birth (515,756) during the 1995–2018 period while between the ages of 15–64. Single mothers were compared with women who experienced the same life event, but without becoming a single mother. The results for women who separated showed that among single mothers, there was a substantial increase in antidepressant use at the time of separation, and only a moderate decline after separation. Among women who experienced widowhood, those who had underage children initially had lower antidepressant use than women without children, but this gap narrowed in the post-widowhood period. In addition, single women experienced more unfavorable mental health trajectories than partnered women around the time they gave birth. Re-partnering was associated with more favorable mental health among all groups of single mothers. Given the growing prevalence of single-parent households, our results underscore the need for context-specific interventions to support single mothers’ mental health.

Effects of Fear and Humor Appeals in Public Service Announcements (PSAs) on Intentions to Purchase Medications via Social Media.

The increasing prevalence of online purchase of medications, specifically via social media platforms, poses significant health risks due to high chances of such medications being substandard and falsified (SF). The current study uses a 2 (persuasive appeal: fear vs. humor) x 3 (message repetition) mixed factorial experiment to investigate the effectiveness of persuasive appeals (on intentions to purchase medications online via social media referrals, mediated by psychological reactance (threat to freedom and anger), attitudes toward the public service announcements (PSAs), and viral behavioral intentions. ANOVA results showed the superiority of humor appeals compared to fear appeals in (1) reducing psychological reactance, (2) igniting favorable responses to the PSA, and (3) marginally reducing the intentions to purchase medications vial social media despite lower online engagement intentions (viral behavioral intentions). Pre-existing risk perceptions moderated these differences. A moderated serial mediation model, conducted using PROCESS models, was examined to assess the mechanism by which persuasive appeals and risk perceptions interact in influencing purchase intentions. Findings are discussed theoretically in regard to extending the psychological reactance model within the digital environment and practically in terms of public health, brand protection, and law enforcement recommendations.

Bored Boys Bet: Predictors of Sports Gambling Behavior by University Students during the COVID-19 Lockdown

A state of emergency was declared on March 27, 2020 in the province of Manitoba due to the COVID-19 pandemic. For three months, the population of Manitoba was confined to their homes; social contact was restricted to grocery shopping, medical appointments and medical prescription purchases.

Immigrants’ health education and economic behaviours: saving rates, social medical insurance and house purchase

Healthy China is a crucial policy for advancing global health, addressing inequality between rural and urban health education, and helping the domestic markets recover after the COVID-19 outbreak. This study combines life cycle mechanisms and safety beliefs to evaluate the long-lasting values of health education. We employed data from the China Migration Dynamic Surveys to examine the economic behaviours of 720,900 immigrants using a robust empirical approach combining an Extended Regression Model (E.R.M.), Average Treatment Effects (A.T.E.), and heterogeneous treatment effects. We find that health education increases participation in social medical insurance and the likelihood of purchasing a house. In contrast, the relationship between health education and saving rates is non-linear effects. Empirically robust heterogeneous treatment effects account for heterogeneity in the previous and the younger generations, as well as urban and rural citizens’ long-run effects of health education. This study’s findings suggest that health education stimulates immigrants’ consumption behaviours; however, extra health education is not desirable. Rural-urban citizenship acquisition bias is found to significantly affect health education.

Criminological and Victimological Support of World and National Security during Quarantine Measures Related to the Spread of Acute Respiratory Disease COVID-19 Caused by Coronavirus Sars-Cov-2

The study examines current challenges faced by Ukrainian legal system in matters of criminological and victimological security of society during quarantine measures related to COVID-19. Using methods of system analysis and scientific design, current legal framework of Ukraine in regulation of public relations was analyzed. The study draws attention to the fact that, Ukraine has improved its legislation on the control of medical purchases and the provision of necessary materials to medical institutions. At the same time, the authorities will have to further improve the framework for patient monitoring and the epidemiological surveillance system in the medical sector.

Swedish community pharmacy employees' knowledge and experience of substandard and falsified medical products: a cross-sectional descriptive survey.

Substandard and falsified medical products are, according to the World Health Organization, a global threat to public health. To evaluate if community pharmacy employees can guide the public to safer medication purchases, their knowledge and experience about SF medical products was examined. A digital questionnaire was distributed to the five dominating pharmacy companies in Sweden, representing 97% of the community pharmacies (1391/1433), giving the theoretical possibility of reaching 6200 employees. Three companies published a link to the questionnaire on their intranets, one distributed the link via e-mail to the responsible pharmacist for quality and knowledge, respectively. The fifth company did not pass on, due to technical problems. Employees aged 18 years or older with customer contact were invited to participate. The questionnaire was available for 74% of all community pharmacies (1067/1433), having approximately 4900 employees with customer contact. The response rate was 5% (228/4900). Of the respondents, 89% were pharmacists (203/228), 84% were women (191/228) and 43% were 35-49 years (98/228). The respondents worked in pharmacies of different size, located both in rural and urban areas. The definition of substandard and falsified medical products was known by 182 of the 228 respondents (80%) and the main source of knowledge was media (61%, 111/228). The common European logo for authorized online pharmacies was not recognized by 74% (169/228). For pharmacy employees to guide the public to safer medication purchases, knowledge about substandard and falsified medical products needs to be enhanced specially about legal international e-commerce.

Does Sustainable Consumption Matter? The Influence of the COVID-19 Pandemic on Medication Use in Brasov, Romania

Sustainable consumption refers to the choice, purchase, use, and disposal of goods so as to enable all people to meet their present and future objective needs. However, panic caused by the gradual onset of the pandemic had a considerable impact on the behavior of consumption and purchase of medication, and the question remains whether sustainable consumption still matters during a crisis or not. The present study aims to analyze whether the pandemic has influenced the behavior of medication use among residents of Brasov County amid panic caused by the virus and to determine the primary sources of information on methods of the prevention and treatment of health conditions. The study focusses on the differences between the two target groups, young people, and adults, considering three socio-demographic factors, such as age, gender, and background. The present research uses two methods of data collection: an interview with 5 doctors and a questionnaire with 543 respondents. This research draws attention to the fact that the behaviors of purchasing and consuming medication during the COVID-19 pandemic has changed due to the spreading of the new virus and the state of emergency, as well as with medication use becoming less sustainable. The results showed that adults were more engaged in the panic buying of medication compared to young people during the pandemic; however, in normal times, young people use more medication. Our study shows that females tend to consume more medicines than males. Moreover, they are more susceptible for seeking media guidance and following advice from the digital realm, because they avoid going to the doctor, especially during the COVID-19 period. Depending on the environment of residence, it was found that people in rural areas generally tend to consume more medication than those in urban areas. However, during the pandemic, the drug use of this category of population has decreased because they do not tend to self-medicate and avoid visiting the doctor because of the fear of becoming contaminated. The results of the research could help to establish measures in order to prevent the panic buying of self-medication and pharmaceuticals, both during pandemics and in normal times, because such behaviors can have negative effects on both health and the environment.

Use of antihypertensive medication and formation of de novo intracranial aneurysms.

Hypertension is a risk factor for subarachnoid hemorrhage and is also considered a risk factor for saccular intracranial aneurysm (sIA) formation. However, there is little direct evidence that antihypertensive medication will reduce sIA formation. The impact of antihypertensive medication on de novo sIA formation was studied in an angiographically followed cohort of 1419 patients. Patients were identified from our population-based Kuopio Intracranial Aneurysm Database, and data on the purchases of antihypertensive medication were obtained from a national registry. Univariate and multivariate analyses were used to investigate the risk factors. Of the 966 sIA patients who were prescribed with antihypertensive medication, 841 patients used the medication regularly; 20 of them had de novo sIA. One hundred and twenty-five patients used the medication irregularly and 12 of them developed de novo sIAs. Four hundred and fifty-three patients did not use antihypertensive medication even though 27 of them had a diagnosis of hypertension, and 10 of them developed de novo sIAs. In the multivariate analysis antihypertensive medication did not significantly reduce de novo sIA formation (hazard ratio [HR] 1.60, 95% confidence interval [CI] 0.84-3.06). Age at primary diagnosis (HR: 0.95, 95%: CI 0.93-0.98) and smoking history (HR: 5.53, 95% CI: 2.77-11.05) were significant risk factors for de novo sIA formation. Also, irregular usage of antihypertensive medication was a significant risk factor (HR: 3.84, 95% CI: 1.59-9.29) for de novo sIA formation. Antihypertensive agents were not associated with a reduction of de novo sIA formation, but irregular use of antihypertensive agents was associated with an increased risk of de novo sIA formation.

Pain medication purchases before and after total hip and knee arthroplasty: a register study of 329,743 arthroplasties.

Background and purposeTotal hip (THA) and knee (TKA) arthroplasty are effective pain treatment in osteoarthritis; however, there are patients with long-term pain and in need of analgesics. We studied purchases of paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and neuropathic pain medication before and after THA or TKA.Patients and methodsWe searched all THA (n = 149,158) and TKA (n = 180,585) cases in Finland between the years 1998 and 2018 and the drug purchases made by patients during 1997–2018 using linked Finnish register data. Drug purchases were studied in 3-month periods.ResultsThe purchases of all analgesics increased from 3 years before operation to 3 months before operation. Around the time of THA or TKA, the purchases of all analgesics spiked to 7–56%, depending on drug. The purchases of all analgesics decreased rapidly during the first 6 months postoperatively. Purchases of paracetamol, NSAIDs, and opioids at 6 months postoperatively (6–23%) were lower than they were at 3 months preoperatively. At 3 years postoperatively, only paracetamol purchases were lower (15–18%) postoperatively than they were 3 years before arthroplasty. NSAID, opioid, and neuropathic pain medication purchases remained higher (4–14%).InterpretationTHA and TKA stop and reduce the preoperative increases in purchases of paracetamol, NSAIDs, and opioids. The purchases of pain medications by THA and TKA patients 1 year after operation are close to those in the general population.

Joint association of socioeconomic circumstances and minor mental health problems with antidepressant medication.

BackgroundDisadvantageous socioeconomic circumstances and minor mental health problems have both been associated with mental disorders, such as depression, but their joint contribution remains unknown.MethodsThe Helsinki Health Study baseline survey (2000–02) of 40- to 60-year-old employees was linked with antidepressant medication data from registers of the Social Insurance Institution of Finland. The analyses were made using logistic regression with first prescribed antidepressant medication purchase during a 10-year follow-up as the outcome. Minor mental health problems were measured by the emotional well-being scale of the RAND-36. Odds ratios were calculated for joint association of the lowest quartile of the emotional well-being scale of the RAND-36 and socioeconomic circumstances. Childhood (parental education and childhood economic difficulties), conventional (education, occupational class and income) and material (housing tenure and current economic difficulties) socioeconomic circumstances were examined. This study included 5450 participants.ResultsMinor mental health problems dominated the joint associations. Minor mental health problems were associated with antidepressant medication irrespective of socioeconomic circumstances whereas only low income, current economic difficulties and living in rented housing showed an association without minor mental health problems at baseline. Marital status, working conditions and BMI and health behaviours had only minimal contributions to the associations.ConclusionsMinor mental health problems were consistently and strongly associated with antidepressant medication and dominated the joint associations with socioeconomic circumstances. Paying attention to minor mental health problems might help prevent mental disorders such as depression.

A qualitative analysis of customers´ expectations towards medication purchases in community pharmacies and other retail places in Lithuania

A qualitative analysis of customers´ expectations towards medication purchases in community pharmacies and other retail places in Lithuania

Data-driven long-term glycaemic control trajectories and their associated health and economic outcomes in Finnish patients with incident type 2 diabetes.

Treatments should be customized to patients to improve patients' health outcomes and maximize the treatment benefits. We aimed to identify meaningful data-driven trajectories of incident type 2 diabetes patients with similarities in glycated haemoglobin (HbA1c) patterns since diagnosis and to examine their clinical and economic relevance. A cohort of 1540 patients diagnosed in 2011-2012 was retrieved from electronic health records covering primary and specialized healthcare in the North Karelia region, Finland. EHRs data were compiled with medication purchase data. Average HbA1c levels, use of medications, and incidence of micro- and macrovascular complications and deaths were measured annually for seven years since T2D diagnosis. Trajectories were identified applying latent class growth models. Differences in 4-year cumulative healthcare costs with 95% confidence intervals (CIs) were estimated with non-parametric bootstrapping. Four distinct trajectories of HbA1c development during 7 years after T2D diagnosis were extracted: patients with "Stable, adequate" (66.1%), "Slowly deteriorating" (24.3%), and "Rapidly deteriorating" glycaemic control (6.2%) as well as "Late diagnosed" patients (3.4%). During the same period, 2.2 (95% CI 1.9-2.6) deaths per 100 person-years occurred in the "Stable, adequate" trajectory increasing to 3.2 (2.4-4.0) in the "Slowly deteriorating", 4.7 (3.1-6.9) in the "Rapidly deteriorating" and 5.2 (2.9-8.7) in the "Late diagnosed" trajectory. Similarly, 3.5 (95% CI 3.0-4.0) micro- and macrovascular complications per 100 person-years occurred in the "Stable, adequate" trajectory increasing to 5.1 (4.1-6.2) in the "Slowly deteriorating", 5.5 (3.6-8.1) in the "Rapidly deteriorating" and 7.3 (4.3-11.8) in the "Late diagnosed" trajectory. Patients in the "Stable, adequate" trajectory had lower accumulated 4-year medication costs than other patients. Data-driven patient trajectories have clinical and economic relevance and could be utilized as a step towards personalized medicine instead of the common "one-fits-for-all" treatment practices.

MP07-11 REAL WORLD MEDICATION PERSISTENCE IN TREATMENT OF WOMEN WITH OVERACTIVE BLADDER ACCORDING TO LARGE SCALE PRESCRIPTION CLAIMS DATA

You have accessJournal of UrologyCME1 May 2022MP07-11 REAL WORLD MEDICATION PERSISTENCE IN TREATMENT OF WOMEN WITH OVERACTIVE BLADDER ACCORDING TO LARGE SCALE PRESCRIPTION CLAIMS DATA Chen Shenhar, Karin Lifshitz, Igor Mintz, Yariv Shtabholtz, Ofer Yossepowitch, Jack Baniel, and Shachar Aharony Chen ShenharChen Shenhar More articles by this author , Karin LifshitzKarin Lifshitz More articles by this author , Igor MintzIgor Mintz More articles by this author , Yariv ShtabholtzYariv Shtabholtz More articles by this author , Ofer YossepowitchOfer Yossepowitch More articles by this author , Jack BanielJack Baniel More articles by this author , and Shachar AharonyShachar Aharony More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002529.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Medical treatments for overactive bladder (OAB) have proven efficacy in controlled trials. However, 1-year medication persistence is reported to be as low as 25% for anticholinergics and 40% for β3 agonists. Real world data on treatment continuation and sequence in case of medication replacement is limited. Our aim was to study actual treatment persistence trends in women initiated on OAB medications. METHODS: We used advanced data-mining techniques to explore the largest regional provider’s medication purchase database, dispensing for over 400,000 patients, for all women initiating OAB pharmacotherapy between 2010 and 2020, and cross-referenced them with patient age, BMI, and smoking status. Medication persistence was measured in days for which the patient was issued a medication, and prescription non-refilling for 90 days was defined as non-persistence. We employed a Sankey diagram to map trends in OAB medication claims and treatment sequence. We further compared medication persistence using Kaplan-Meier survival curves and pairwise log-rank analysis. We studied the effects of age and smoking status on medication continuation using logistic regression modelling. RESULTS: Between 2010 and 2020, 46,079 women made 791,681 unique acquisitions of OAB medications. Overall treatment persistence rates were 49% for 30 days, 34% for 90 days, and 9% for a year. The 1-year persistence rate was highest for Mirabegron (10%) and Oxybutynin (11%) compared with all other medications (4%) (p<0.005). Overall persistence rates were unchanged when stratifying by time of Mirabegron acceptance into insurance coverage (p>0.05). Patients persisting with treatment for over 90 days were 5 years older compared to their non-persisting counterparts (mean age 72.8±14.3 vs. 67.5±16.5 years, p<0.05). Non-smokers had an odds ratio of 1.1 [95% CI: 1.04-1.16] of persistence when compared to smokers. CONCLUSIONS: Real-world OAB pharmacotherapy persistence rates are lower than previously reported. The added option of Mirabegron did not seem to improve these rates. Source of Funding: none © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e119 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Chen Shenhar More articles by this author Karin Lifshitz More articles by this author Igor Mintz More articles by this author Yariv Shtabholtz More articles by this author Ofer Yossepowitch More articles by this author Jack Baniel More articles by this author Shachar Aharony More articles by this author Expand All Advertisement PDF DownloadLoading ...

Misuse of prescribed psychotropic medication and drug crime offending: A follow-up case-control study of former adolescent psychiatric inpatients.

BackgroundVarious psychotropic prescription drugs are known to have potential for misuse. Among teenagers, non‐medical use of prescription drugs may predate illicit drug use or occur concomitantly.AimsOur aim was to examine prescriptions of psychotropic medications among drug crime offenders and non‐criminal controls in a psychiatric inpatient cohort of 13–17‐year‐olds. Our research question was: were prescribed psychotropic and potentially addictive drugs associated with later drug crime offending.MethodsOur sample was of all 60 adolescents who had been convicted of a drug crime by young adulthood with a twice‐sized control group, matched for gender, age and family‐type, from a cohort of 508 adolescents consecutively admitted to a psychiatric inpatient care in Finland between April 2001 and March 2006. Adolescence‐related information on substance use and psychiatric disorders was obtained by semi‐structured interviews. Follow‐up information on crimes and medication purchases was obtained from Finnish nationwide registers. The association of studied factors to drug crime offending was examined using stepwise binary logistic regression analysis.Results75% of drug crime offenders and 47% of non‐criminal controls had used addictive psychotropic medications during the follow‐up period (p < 0.001). 74% of all drug crime offenders' purchases of prescribed addictive drugs occurred within the year preceding drug crimes. Of addictive drugs, the use of clonazepam and gabapentinoids was most likely to associate with drug crime offending (AOR 7.77, p < 0.001). Conduct and substance use disorders diagnosed in adolescence (AOR 3.49, p = 0.010; AOR 2.34, p = 0.050) were predictors for drug crime offending.ConclusionsOur findings suggest that, when treating young adults with conduct disorder and a history of substance use, physicians should prescribe addictive medications with caution, favouring instead non‐addictive medications complemented by psychosocial interventions.