Clinical therapeutics
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Clinical therapeutics · Aug 2006
Randomized Controlled Trial Comparative StudyComparative sensitivity of stopwatch methodology and conventional pain assessment measures for detecting early response to triptans in migraine: results of a randomized, open-label pilot study.
The standard measure of efficacy used in migraine trials is a 4-point patient-rated headache pain intensity (HPI) scale. However, it has been suggested that using a stopwatch to measure the time to meaningful pain relief can provide a more precise measurement of treatment response. ⋯ The results of this open-label pilot study suggest the convergent validity of 3 pain-assessment methods in migraine, but indicate that the use of a stopwatch may be a more sensitive method for detecting between-group differences.
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Clinical therapeutics · Aug 2006
Comparative StudyComparison of medication adherence and associated health care costs after introduction of pioglitazone treatment in African Americans versus all other races in patients with type 2 diabetes mellitus: a retrospective data analysis.
The aim of this study was to compare treatment adherence and health care costs in African Americans versus all other races (All Others) in patients with type 2 diabetes mellitus starting treatment with pioglitazone. ⋯ On multivariate analysis, this study found no significant differences in treatment adherence between African Americans versus all other races in this population of diabetic patients enrolled in a Medicaid program (query dates: July 1, 2000, to June 30, 2003). A higher adherence rate was associated with significantly lower diabetes-related and total health care costs in this population.
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Clinical therapeutics · Aug 2006
A cross-national study of prescription nonadherence due to cost: data from the Joint Canada-United States Survey of Health.
In Canada and the United States, patients who have difficulty paying for prescribed medications are less likely to obtain them and may experience increased risks for morbidity and mortality and/or increased health care costs due to nonadherence. As prescription drug costs have risen, the ability to pay for medications has emerged as a critical public health issue. ⋯ The results of this analysis suggest that people with low incomes and inadequate insurance, as well as those with poor health and/or chronic symptoms, are more likely to report failing to fill a prescription due to cost. The overall rate of cost-associated nonadherence was significantly higher in the United States than in Canada, even when other person-level factors were controlled for, including health insurance and prescription-drug coverage.
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Clinical therapeutics · Aug 2006
Comparative StudyCost-effectiveness analysis of linezolid compared with vancomycin for the treatment of nosocomial pneumonia caused by methicillin-resistant Staphylococcus aureus.
This study compared the cost-effectiveness of linezolid and vancomycin in the treatment of patients with nosocomial pneumonia (NP) caused by methicillin-resistant Staphylococcus aureus (MRSA). ⋯ The higher acquisition cost of linezolid was almost completely offset by improved survival and a reduction in health care costs associated with improved survival. As a result, linezolid was almost cost-neutral compared with vancomycin in the treatment of NP caused by MRSA.
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Clinical therapeutics · Aug 2006
Patterns of dosage changes with transdermal buprenorphine and transdermal fentanyl for the treatment of noncancer and cancer pain: a retrospective data analysis in Germany.
Previous studies have suggested that buprenorphine may have a low association with tolerance development compared with other strong opioids. In a previous study by our group, mean cohort and intraindividual dosage increases over an entire course of treatment and on a per-day basis were significantly lower with transdermal (TD) buprenorphine than with TD fentanyl. However, no information concerning the relationship between qualitative and quantitative dose changes is available. ⋯ In this retrospective data analysis, compared with TD buprenorphine, the increase in mean daily dosage was significantly greater in patients treated with TD fentanyl. Also, compared with TD buprenorphine, alternating dosage changes were seen in a significantly greater proportion of patients receiving TD fentanyl. On the other hand, a significantly greater proportion of patients treated with TD buprenorphine had stable dosages over their entire treatment periods.