Prescription Redemption Research Articles

Susceptibility to and severity of SARS-CoV-2 infection according to prescription drug use-an observational study of 46,506 Danish healthcare workers.

It is not well investigated whether exposure to specific drug classes is associated with COVID-19. We investigated the risk of SARS-CoV-2 infection and severe COVID-19 among healthcare workers according to prescription drug use. We conducted an observational study among Danish healthcare workers. SARS-CoV-2 positivity was defined as a positive PCR/ELISA test throughout 2020 and severe COVID-19 as any above 48-hour hospitalization within 14 days after infection. Patient characteristics came from online surveys while data on SARS-CoV-2, drugs and hospitalizations came from Danish Health Registers. Infected individuals were matched with uninfected controls based on age, sex, and chronic diseases. Drug exposure was defined as any prescription redemption in the past six and one month(s) before infection for each drug class. Models assessing the risk of infection (conditional logistic regression) and severe COVID-19 (logistic regressions) versus drug usage were adjusted for BMI, smoking, alcohol, education, region, and patient contact when possible. We matched 5,710 SARS-CoV-2-infected cases with 57,021 controls. The odds of infection were reduced by calcium channel blocker (adjusted odds ratio (aOR) 0.81, 95% Confidence Interval (CI): 0.66-1.00) and vasoprotective drug (aOR 0.77, CI: 0.62-0.95) usage during the six months before infection compared to no usage. Exposure to antibacterials in the past month increased the odds of infection (aOR 1.27, CI: 1.09-1.48). Among infected participants, the odds of severe COVID-19 were higher with usage of almost any investigated drug, especially, diuretics (crude odds radio (OR) 4.82, CI:2.15-10.83), obstructive airway disease drugs (OR 4.49, CI: 2.49-8.08), and antibacterials (OR 2.74 CI:1.62-4.61). In conclusion, antibacterials were associated with more SARS-CoV-2 infections and calcium channel blockers with less. Once infected, users of prescription drugs had higher odds of developing severe COVID-19. These findings suggest a need for studies to clarify interactions between specific drug groups, behaviour, known risk factors, and disease susceptibility/severity.

Self-rated health in preadolescents as a predictor for prescription redemption and hospital contacts

Abstract Background The decline in self-rated health among children and adolescents raises concerns for their overall well-being and future health outcomes. We examined whether self-rated health in preadolescence predicts both psychiatric and somatic prescription redemption and hospital contacts in later adolescence. Methods This cohort study is part of the Danish National Birth Cohort and focuses on children born between 1996 and 2003. A survey was distributed to 96,382 preadolescents aged 11, who were then followed from 2010 to 2018 (average follow-up of 6.9 years). Data on prescriptions and hospital contacts were obtained from Danish registries. Negative binomial regression was employed to calculate the incidence rate ratio (IRR), comparing preadolescent children who rated their health as poor (‘Not So Good’/’Poor’) to those who rated it as good (‘Excellent’/’Good’). Results Of the 47,365 (49.1%) 11-year-old preadolescents who participated in this study, 5.3% reported experiencing poor self-rated health. Overall, adjusted analyses revealed higher rates of prescription redemptions (IRR 1.63 [95% CI: 1.53; 1.73]) and hospital contacts (IRR 1.86 [95% CI: 1.74; 1.99]) in these children. Poor self-rated health in preadolescence was associated with more somatic (IRR 1.51 [95% CI: 1.40; 1.62]) and psychiatric (IRR 3.04 [95% CI: 2.59; 3.57]) prescriptions, as well as somatic (IRR 1.61 [95% CI: 1.51; 1.72]) and psychiatric (IRR 2.80 [95% CI: 2.42; 3.25]) hospital contacts in adolescence, with similar associations across sexes. Conclusions Poor self-rated health in preadolescence is associated with higher rates of prescription redemption and hospital visits in adolescence, suggesting that perceptions of health in early life influence long-term well-being, especially regarding psychiatric health. This straightforward self-rated health measure offers healthcare professionals valuable insights for identifying children who may require support and early intervention. Key messages • Poor self-rated health in preadolescence predicts higher prescription redemption and hospital visits in adolescence, especially regarding psychiatric health. • Simple self-assessment of health in childhood may have the potential to help identify those needing support and early intervention for long-term well-being.

Temporal trends in treatment patterns, morbidity, and mortality in patients with new-onset heart failure compared to heart failure survivors: a nationwide 23-year perspective

Abstract Background New therapy options have improved the prognosis of heart failure (HF) over recent decades. However, temporal trends in the prognosis and treatment disparities between patients with new-onset HF and HF survivors remain unexplored. Purpose To investigate temporal trends in HF treatment patterns, worsening HF and all-cause mortality, in new-onset HF patients compared to HF survivors. Methods We defined two separate cohorts of patients with HF, using the Danish nationwide registers. One cohort comprised all patients with new-onset HF each year from 1996 to 2018, included at the date of HF diagnosis (new-onset HF patients). The second cohort comprised patients with HF who have survived at least three years since being diagnosed with HF, included on January 1st of each year from 1996 to 2018 (HF survivors). Patients were allowed to contribute in both cohorts. The proportion of patients in guideline recommended therapy and the absolute five-year risk of worsening HF and all-cause mortality were assessed in the two cohorts separately, accounting for competing risks where relevant. Results From 1996 to 2018, the proportion of HF survivors tripled, while the number of yearly new-onset HF patients remained constant (figure 1). The proportion of new-onset HF patients who redeemed a prescription of BB increased from 17.1% in 1996 to 78.2% in 2018, while it increased from 15.9% to 69.4% in HF survivors during the same period. The proportion of patients in ACEi/ARB therapy increased from 49.1% to 81.5% in the new-onset HF patients, while it increased from 37.8% to 69.0% in HF survivors. The proportion of patients in MRA therapy increased from 14.4 to 33.0% in those with new-onset HF, and from 19.1% to 24.8% in HF survivors. The absolute risk (AR)[±95CI] for all-cause mortality decreased from 68.4% [67.9-68.9] in the first year group (1996-2000) to 45.7% [45.0-46.3] in the latest year group (2013-2018) for new-onset HF patients, while it decreased from 58.4% [58.2-58.9] to 39.7% [39.4-40.0] for the HF survivors. Additionally, the AR for worsening HF went from 27.4% [26.9-27.8] in the first year group to 27.8% [27.3-28.2] in the latest year group for the new-onset HF patients, whereas it for the HF survivors decreased from 19.6% [19.3-20.0] to 16.7% [16.4-19.9]. Conclusions Over a 23-year period, the annual number of patients with incident HF has remained constant while the number of HF survivors has increased by 304%. Although HF survivors show a lower prescription redemption prevalence for essential HF medications compared to incident HF patients, they exhibit significantly lower risk of all-cause mortality and worsening HF.Figure 1:OverviewFigure 2:Prescription redememption rates

Influence of the Quality of Pharmacy Services and Non-Pharmacy on the Decision to Redeem the Prescription and Its Impact on Retreatment of General Outpatient at Pasar Minggu Hospital

The study examines the influence of pharmaceutical and non-pharmaceutical service quality on prescription redemption decisions and subsequent re-treatment decisions among general outpatients at Pasar Minggu Regional Hospital. The hospital has faced challenges, including a decline in outpatient visits and filled prescriptions, affecting its revenue during the 2022-2023 period. Patient perceptions of the pharmacy services significantly impact their decision to return for further medical care. The research aims to assess both direct and indirect effects of service quality on prescription redemption and re-treatment decisions. The study employs a verification approach with a cross-sectional design, using accidental sampling to survey 342 general outpatients between October 2023 and February 2024. Data were analyzed descriptively and inferentially using SEM PLS 3.0, encompassing both outer and inner model analyses through PLS Algorithm, Bootstrapping, and Blindfolding techniques. The findings reveal that the quality of pharmaceutical and non-pharmaceutical services significantly influences the decision to redeem a prescription (P = 0.000). Moreover, non-pharmaceutical service quality and the decision to redeem a prescription significantly affect the decision to re-medicate (P = 0.002 and 0.000, respectively). However, pharmaceutical service quality alone does not positively impact repeat treatment (P = 0.041). Both service variables have a significant indirect effect on re-treatment decisions through the mediating role of prescription redemption (P = 0.000).

Cost of illness and labour market disaffiliation among patients with migraine discontinuing triptan treatment: A Danish nationwide register study from 1995 to 2021.

Migraine presents significant health and economic challenges. Despite the widespread use of triptans, some patients discontinue them because of insufficient relief or adverse effects. Using national registers, the present study investigates the excess costs and labour market disaffiliation of Danish patients discontinuing triptan treatment. The study included all individuals ≥18 years ("patients") who discontinued redemption of triptan prescriptions between 1998 and 2019. They were categorized by number of distinct triptans redeemed before discontinuation: one, two or three or more. A control group was established from the general population without triptan redemptions, three per patient, matched by year of birth, sex and region of residence. We estimated excess direct and indirect costs from 5 years prior ("year -5") to 10 years post ("year 10") the first triptan redemption. We identified 211,026 patients who discontinued triptan redemption, 82% after one, 14% after two and 4% after three or more distinct triptans. Over the period from year -5 to year 10, average excess healthcare costs per patient in these cohorts were EUR 9,554, EUR 10,942 and EUR 12,812 respectively. Over the same period, these patients earned EUR 27,964, EUR 35,920 and EUR 50,076 less than their respective controls, and received higher public transfer payments of EUR 20,181, EUR 23,264 and EUR 26,459. Triptan discontinuers, who appear to have exhausted all current treatment avenues, face high direct and very high indirect excess costs attributable to migraine, and experience substantial increased labour market disaffiliation.

Use of medication in pregnancy on the rise: Study on 1.4million Danish pregnancies from 1998 to 2018.

Maternal demographics have evolved, and more women than ever enter pregnancy with preexisting comorbidity and with potentially complex medication exposure, including polypharmacy (concomitant intake of multiple medications). This study aims to describe the evolution of medication use in pregnancy in Denmark from 1998 to 2018 with special focus on polypharmacy, patterns of use, and underlying demographics. A Danish nationwide historical registry study based on all clinically recognized pregnancies with a gestation ≥10 weeks between 1998 and 2018. Medication use was estimated by redemption of prescriptions during pregnancy. Among a total of 1 402 327 clinically recognized pregnancies, redemption of at least one prescription medication during pregnancy increased from 56.9% in 1998 to 63.3% in 2018, coinciding with an increased use of polypharmacy (from 24.8% in 1998 to 35.2% in 2018). The prevalence of pregnant women who used medications for chronic conditions increased more than the prevalence of women treated for occasional or short-time conditions. Redemption of one or multiple prescription medications during pregnancy was mostly seen among pregnant women ≥35 years of age. However, pregnant women <25 years old exhibited the largest increase in medication use during the study period. Medication use in general, and polypharmacy in particular, increased from 1998 to 2008, possibly as the result of an increased prevalence of pregnant women with chronic conditions requiring pharmacological treatment. Notably, a marked maternal age-based discrepancy in usage pattern was observed, highlighting the need for further research in this area. The rise in the prevalence of polypharmacy during pregnancy underscores the need for pharmacovigilance to monitor adverse effects. Future studies should investigate the patterns of polypharmacy and the accompanying maternal and fetal risks.

Caregiver-reported barriers to engagement in a paediatric fresh fruit and vegetable prescription programme.

Paediatric fruit and vegetable prescription programmes hold promise in improving food security and dietary patterns among youth. However, programme success is largely dependent upon caregiver and family engagement. The current study sought to gain a better understanding of environmental barriers to engagement in a paediatric fruit and vegetable prescription programme in one low-income, urban community (Flint, Michigan, USA). Following the implementation of a paediatric fruit and vegetable prescription programme, researchers conducted thirty-two semi-structured interviews with caregivers. Researchers explored caregivers' understanding of the fruit and vegetable prescription programme, barriers to programme engagement, and recommendations for improvement. Telephone interviews were transcribed for textual analysis. Researchers used thematic analysis to examine qualitative data, determine patterns across transcripts, and develop emerging themes. Researchers concluded interviews when data saturation was reached. The majority of participants were female (94%), African American (66%), and residents of Flint (72%). Five recurrent themes emerged: (1) nutrition security; (2) prescription distribution; (3) prescription redemption; (4) educational supports; and (5) programme modifications. Although caregivers indicated that the prescription programme addressed household food insecurity, environmental barriers to engagement were apparent. Caregivers provided suggestions, such as partnering with large grocery stores and developing digital prescriptions, to address programme engagement challenges. Fundamental to the success of fruit and vegetable prescription programmes is the understanding of barriers to engagement from the perspective of participants. This study explores challenges with one paediatric fruit and vegetable prescription programme and provides actionable solutions, from the viewpoint of caregivers, to address these challenges.

Association between doxycycline use and long-term functioning in patients with schizophrenia

Importance and objectiveThe brain-penetrant tetracycline antibiotics, minocycline and doxycycline, have been proposed as potential candidate drugs for treatment of schizophrenia, based on preclinical studies and clinical trials. A potential long-term beneficial effect of these antibiotics for schizophrenia patients has not been investigated. This study was designed to determine if redemption of doxycycline prescription in schizophrenia is associated with decreased incidence of disability pension, a proxy for long-term functioning. DesignWe performed a population-based cohort study with data from schizophrenia patients available through the Danish registers. Survival analysis models with time-varying covariates were constructed to assess incidence rate ratios (IRR) of disability pension after exposure to doxycycline or a non-brain penetrant tetracycline, defined as at least one filled prescription. The analysis was adjusted for age, sex, calendar year, parental psychiatric status and educational level. ResultsWe used data from 11,157 individuals with schizophrenia (4,945 female and 6,212 male; average age 22.4 years old, standard deviation (std) 4.50). 718 of these were exposed to brain-penetrant doxycycline, and 1,498 individuals redeemed a prescription of one or more of the non-brain-penetrant tetracyclines. The average years at risk per person in this cohort was 4.9, and 2,901 individuals received disability pension in the follow-up period. There was a significantly lower incidence rate of disability pension in schizophrenia patients who had redeemed doxycycline compared to patients who did not redeem a prescription of any tetracycline antibiotics (Incidence rate ratio (IRR) 0.68; 95 % CI 0.56, 0.83). There was also a significant lower rate of disability pension in schizophrenia patients who redeemed doxycycline compared to individuals who redeemed a prescription of one of the non-brain penetrant tetracycline antibiotics (IRR 0.69 95 % CI 0.55, 0.87). ConclusionsIn this observational study, doxycycline exposure is associated with a reduced incidence of disability pension. These data support further studies on the potential long term neuroprotective effects of doxycycline and level of functioning in schizophrenia patients.

INTERIOR METAVERSE TECHNOLOGY IMPLEMENTATION TO SUPPORT THE STANDARD OF PHARMACY SERVICES

Pharmacy services which accessible in the community are drug store facilities such as pharmacies. Pharmacy services are more than just selling drugs; there are consultations the diseases, the redemption of prescriptions from doctors, and sharing about healthy living with the pharmacist on duty. The School of Pharmacy, Bandung Institute of Technology (SF ITB), was chosen for the case study. The vision and mission of the SF ITB Educational Pharmacy are to implement and demonstrate pharmaceutical services according to standards. However, the lack of enthusiasm from visitors hampers this to be able to consult with pharmacists. The interior metaverse technology method is expected to increase visitor enthusiasm and socialize the service standards to residents, especially future pharmacist candidates. The interior redesign of the SF ITB pharmacy is processed and combined with Virtual Reality (VR) glasses to support pharmacy interior design standards that optimise pharmacy services. The results show that interior metaverse technology received positive feedback from ITB pharmacy students and staff. The respondent’s enthusiasm for pharmaceutical service standards also increased after seeing the interior design of the pharmacy with immersive. These two results show the positive trend of metaverse technology in increasing the visualisation to gain the standart.&#x0D; Keyword : Interior, Virtual Reality, Metaverse, Immersive, Pharmacy

Pediatric Fruit and Vegetable Prescriptions: Impact of Visit Type on Prescription Distribution and Redemption Rates

Pediatric Fruit and Vegetable Prescriptions: Impact of Visit Type on Prescription Distribution and Redemption Rates

Caregiver-Reported Barriers to Redemption of Pediatric Fruit and Vegetable Prescriptions

Caregiver-Reported Barriers to Redemption of Pediatric Fruit and Vegetable Prescriptions

PSYCHIATRIC ADVERSE EFFECTS OF MONTELUKAST - A NATIONWIDE COHORT STUDY.

Recent observational studies suggest that the leukotriene receptor antagonist montelukast may have neuropsychiatric adverse effects, however, results are conflicting. To assess if montelukast exposure in adults with asthma is associated with onset of neuropsychiatric adverse events using data from the Danish nationwide health registers. Individuals ≥18 years with either ≥1 prescription redemption of inhaled corticosteroids (ICS) or with at least one hospital contact with asthma as the main diagnosis between January 1, 2011 and December 31, 2018 were included. Montelukast exposure was assessed as a time-dependent variable. The two outcomes of interest were: use of neuropsychiatric medicine including antidepressants, antipsychotics, anxiolytics, lithium and medication used for attention-deficit/hyperactivity disorder (outcome 1), and hospital contacts with a neuropsychiatric diagnosis (outcome 2), within 90 days of exposure to montelukast. Initiation of montelukast was significantly associated with outcome 1: use of neuropsychiatric medicine (HR (95% CI) = 1.14 (1.08-1.20, p <0.0001). In the assessment of outcome 2: hospital contacts with a neuropsychiatric diagnosis, a significant risk associated with montelukast initiation was found only in the youngest age groups (HR (95% CI) = 1.28 (1.12-1.47), p<0.001 and 1.16 (1.02-1.31), p<0.05, for age group 18-29 and 30-44, respectively). Age-stratified analyses showed that the risk of both outcomes increased with decreasing age, with the highest risk seen in patients aged 18-29. Among younger individuals, montelukast use was significantly associated with an increased risk of neuropsychiatric events such as use of neuropsychiatric medicine and hospital treatment. Clinicians should increase awareness of such adverse effects when prescribing montelukast.

Acceptability and Feasibility of a Mobile Phone Application to Support HIV Pre-exposure Prophylaxis Among Women with Opioid Use Disorder.

Despite evidence supporting HIV pre-exposure prophylaxis (PrEP) effectiveness, very few women with opioid use disorder (OUD) take PrEP. Interventions that improve medication assisted treatment (MAT) uptake and adherence may also be beneficial for PrEP. The reSET-O mobile phone app is a component of the evidence-based Therapeutic Education System, which improves retention and abstinence for people with OUD. To better understand use of this mobile health tool as a support for PrEP among women with OUD, pre-implementation contextual inquiry is needed. Therefore, we set out to assess target user characteristics, implementation barriers, feasibility, and acceptability of reSET-O. We recruited women with OUD receiving care from a community-based organization in Philadelphia to complete semi-structured interviews. All participants were prescribed reSET-O. We interviewed 20 participants (average age 37 years; 70% white, 15% Hispanic, 5% Black) from 5/2021 to 2/2022. We used an integrated analysis approach combining modified grounded theory and implementation science constructs. Half reported recent injection drug use, and 6 were taking buprenorphine. Mental health symptoms were common, and half described engaging in transactional sex. The majority expressed strong interest in PrEP. Participants reported the app would be highly acceptable for PrEP and MAT adherence support, but only two redeemed the prescription. The most common barriers included phone and internet access. Our findings highlight potential implementation challenges for the use of such an app to support PrEP use in this population. Poor uptake of the app at follow-up indicates that initial prescription redemption is a major barrier to reSET-O implementation.

Patient Satisfaction in Prescription Redemption at the Pharmacy Unit of X Hospital Surabaya

Background: One of the main services in hospitals are the pharmacy department. Pharmaceutical services are expected to be carried out according to established standards, to provide excellent service to patients.&#x0D; Aims: To determine the relationship between the quality of pharmaceutical services and patient satisfaction in the pharmaceutical installation of X Hospital Surabaya&#x0D; Methods: Quantitative research with cross sectional study design. The inclusion criteria in this study were patients/patients' families, aged 20-65 years, and willing to fill out a complete questionnaire. The independent variable is the quality of pharmaceutical services at X Hospital, the dependent variable is patient satisfaction at the X Hospital pharmacy installation. The study population was all patients both inpatient and outpatient at X Hospital, with a minimum sample size of 53 people.&#x0D; Results: Most of the respondents were female (60.38%), aged &gt; 60 years (49.06%) with polyclinic visits mostly 3-4 times and most were college graduates (PT) (43.40%). There was a relationship between satisfaction of respondents with redemption process of drug prescriptions at the Pharmacy Unit of X Hospital Surabaya (p= 0.000 (α≤0.05) and r = 0.498). This shows that the respondents' expectations of the tangible, reliability, responsiveness, assurance and empathy components were well fulfilled. Satisfaction from several of these dimensions indicates a good match between the quality of service at the X Hospital Pharmacy Unit and the level of patient satisfaction.&#x0D; Conclusion: The quality of service at the Pharmacy Installation of X Hospital must be maintained and improved to provide satisfaction to the community. Accuracy in carrying out procedures and supported by the optimization of tangible components, reliability, responsiveness, assurance and empathy can certainly be a form of commitment in maintaining the quality of service in hospitals

Free-of-charge dispensing of antipsychotics for schizophrenia in Denmark: Impact on the nationwide prescription registry and redemption of somatic medications.

ObjectiveFree‐of‐charge dispensing of antipsychotics for schizophrenia was introduced in Denmark around 2008. However, free‐of‐charge dispensing is not recorded in the Danish National Prescription Register (DNPR), potentially introducing bias and misclassification.MethodsWe identified all 30 275 individuals with a first‐episode schizophrenia diagnosis in Denmark between 1 January 1999 and 1 March 2017 including all redeemed prescriptions registered in the DNPR during the 2 years after the schizophrenia diagnosis. For each calendar year, we calculated the proportion of individuals who had filled ≥1 prescription for psychotropic and/or somatic medications within the first 2 years after the schizophrenia diagnosis.ResultsFrom 2007 to 2017, the proportion of individuals with prescription‐records for any psychotropic medication during the 2 years after the schizophrenia diagnosis decreased from 88% to 74%, particularly antipsychotics (from 83% to 61%) and antidepressants (from 49% to 35%). This was particularly observed among those aged 18–30 years at the schizophrenia diagnosis. A similar decrease was not observed for prescription‐records of somatic medications.ConclusionThe introduction of free‐of‐charge antipsychotics has affected the redemption of specific psychotropic drugs in the DNPR in first‐episode schizophrenia. This limitation needs to be considered in register‐based studies and emphasizes the need to identify solutions.

Impact of COVID-19 Pandemic on the Fruit and Vegetable Prescription Program in a Pediatric Clinic

ObjectivesHurley Children’s Clinic’s novel fruit and vegetable prescription program aims to improve nutrition intake, household food security, and nutrition access. Children receive $15 prescriptions for fruits and vegetables redeemable at the Flint Farmers’ Market or through the mobile market, Flint Fresh, for a home delivered produce box. The COVID-19 pandemic has spread worldwide, resulting in a national decrease in pediatric visits. Children missed routine well-child and health maintenance visits, including necessary vaccinations and screenings. The aim of this evaluation is to better understand how the pandemic impacted the distribution and redemption of fruit and vegetable prescriptions. MethodsUsing descriptive statistics and chi-square analysis, rates of prescription and redemption before and during the waves of pandemic will be examined at two participating Hurley clinics. Prescription rates reflect provider-driven EMR orders, and redemption rates reflect patient-driven prescriptions submitted in that month to vendors in exchange for produce. Surge one of the pandemic will be defined as March 2020-June 2020; surge two will be defined as November 2020-February 2021. Additionally, change in clinic visit volume will be analyzed. ResultsWell-child visits decreased by 21% during the pandemic period. Preliminary results reveal prescription rate decreased from 74.9% the year before the pandemic (March 2019-February 2020) to 59.4% (p < 0.001) the year following the start of the pandemic (March 2020-February 2021). Redemption through Flint Fresh delivered produce boxes increased by 64.7%. Surge-specific time period analysis and redemption rate statistics are being finalized. ConclusionsRates of fruit and vegetable prescriptions significantly decreased during the pandemic, with a likely associated decrease in redemption rates. This is concerning as Flint’s pre-existing nutrition insecurity was exacerbated by the pandemic due to the concomitant economic crisis resulting from rise in unemployment and poverty. Efforts to improve rates should be considered including targeted outreach to patients who missed visits, enhanced telehealth prescribing, provider education, and promotion of COVID-safe home delivered produce boxes. Further analysis will examine impact of case surges and quality improvement strategies. Funding SourcesHurley.

Assessment of a Fruit and Vegetable Prescription Program in the Northern Manhattan Community

This study aimed to assess whether produce prescription redemption was associated with food insecurity (FI), sociodemographics, and nutrition-related health measures, and to identify factors affecting participation. Retrospective, cross-sectional study. Patients, equally divided between groups who redeemed and did not redeem prescriptions, completed a follow-up survey. Northern Manhattan, NY. 242 patients referred to Nutrition at an academic medical center between June and November 2019. All patients referred to Nutrition received prescriptions for produce at local Greenmarkets (patients with FI received $20; other patients received $10). We assessed patient satisfaction and factors impacting participation. Sociodemographics and nutrition-related health measures were extracted from medical records. The χ2 test for categorical data and Student's t-test for continuous variables. Prescription redeemers were significantly more likely to be very satisfied with the program (P < .001), have FI (P < .01), and have elevated hemoglobin A1C than non-redeemers (6.3 vs 5.5%, P < .001). Distance, time constraints, and forgetting or losing the prescription were common barriers, while convenience and valuing healthy eating facilitated redemption. Higher FI and worse hemoglobin A1c in patients who redeemed prescriptions suggests that our program reaches the target audience: patients needing food assistance and a healthier diet. Awareness of barriers offers areas for improvement. This provides a feasible model for hospital investment to increase access to produce to improve health and health equity.

Invited Perspective: Diabetes and Road Traffic Noise at the Most and Least Exposed Façade.

Invited Perspective: Diabetes and Road Traffic Noise at the Most and Least Exposed Façade.

Desloratadine Exposure and Incidence of Seizure: A Nordic Post-authorization Safety Study Using a New-User Cohort Study Design, 2001-2015.

IntroductionA small number of adverse events of seizure in patients using desloratadine (DL) have been reported. The European Medicines Agency requested a post-authorization safety study to investigate whether there is an association between DL exposure and seizure.ObjectiveThe aim was to study the association between DL exposure and incidence of first seizure.MethodsA new-user cohort study of individuals redeeming a first-ever prescription of DL in Denmark, Finland, Norway, and Sweden in 2001–2015 was conducted. DL exposure was defined as days’ supply plus a 4-week grace period. DL unexposed periods were initiated 27 weeks after DL prescription redemption. Poisson regression was used to estimate the adjusted incidence rate and adjusted incidence rate ratio (aIRR) of incident seizure.ResultsA total of 1,807,347 first-ever DL users were included in the study, with 49.3% male and a mean age of 29.5 years at inclusion; 20.3% were children aged 0–5 years. The adjusted incidence rates of seizure were 21.7 and 31.6 per 100,000 person-years during DL unexposed and exposed periods, respectively. A 46% increased incidence rate of seizure was found during DL exposed periods (aIRR = 1.46, 95% confidence interval [CI] 1.34–1.59). The aIRR ranged from 1.85 (95% CI 1.65–2.08) in children aged 0–5 years to 1.01 in adults aged 20 years or more (95% CI 0.85–1.19).ConclusionThis study found an increased incidence rate of seizure during DL exposed periods as compared to unexposed periods among individuals younger than 20 years. No difference in incidence rate of seizure was observed in adults between DL exposed and unexposed.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40264-021-01106-7.

Using multiple random index dates with the reverse waiting time distribution improves precision of estimated prescription durations.

To improve the precision of prescription duration estimates when using the reverse waiting time distribution (rWTD). For each patient we uniformly sampled multiple random index dates within a sampling window of length . For each index date, we identified the last preceding prescription redemption, if any, within distance . Based on all pairs of last prescription and index date, we estimated prescription durations using the rWTD with robust variance estimation. In simulation studies with increasing misspecification we investigated bias, root mean square error (RMSE) and coverage probability of the rWTD using multiple index dates (1, 5, 10, and 20). We applied the method to Danish data on warfarin prescriptions from 2013 to 2014 stratifying by and adjusting for sex and age. In simulation scenarios without misspecification, the relative bias was negligible (-0.04% to 0.01%) and nominal coverage probabilities almost retained (93.8%-95.4%). RMSE decreased with the number of random index dates (e.g., from 1.3 with 1 index date to 0.6 days with 5). With misspecification, the relative bias was higher irrespective of the number of index dates. Precision increased with the number of index dates, and hence coverage probabilities decreased. When estimating durations of warfarin prescriptions in Denmark, precision increased with number of index dates, in particular in strata with few patients (e.g., men 90+ years: width of 95% confidence interval was 16.2 days with 5 index dates versus 35.4 with 1). Increasing the number of random index dates used with the rWTD improved precision without affecting bias.