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Article ; Online: Patient experience and unmet needs in high-risk nonmuscle-invasive bladder cancer: Insights from qualitative interviews and a cross-sectional survey.

Kopenhafer, Lewis / Thompson, Allison / Chang, Jane / Sikirica, Slaven / Masters, Elizabeth T / Cappelleri, Joseph C / Peck, Eugenia Y / Maculaitis, Martine C

Urologic oncology

2024 Volume 42, Issue 3, Page(s) 70.e1–70.e10

Abstract: Objectives: To evaluate patient experience, unmet needs, and burden among patients with high-risk nonmuscle-invasive bladder cancer (HR-NMIBC) treated with Bacillus Calmette-Guérin (BCG).: Methods: This cross-sectional study included HR-NMIBC ... ...

Abstract	Objectives: To evaluate patient experience, unmet needs, and burden among patients with high-risk nonmuscle-invasive bladder cancer (HR-NMIBC) treated with Bacillus Calmette-Guérin (BCG). Methods: This cross-sectional study included HR-NMIBC patients who received BCG treatment in the past 3 years. The study, preceded by a focused literature review, was conducted in 2 phases: 1) qualitative interviews with 32 patients in the United States (US), France, Germany, and United Kingdom (UK) and 2) quantitative survey of 150 patients in the US. Both phases of the study assessed patient characteristics, treatment history, experience, and perceptions, as well as side effects, pain, discomfort, and time burden associated with BCG treatment. The quantitative survey included additional items related to BCG treatment satisfaction, health-related quality of life (HRQoL), productivity, and healthcare resource utilization. Descriptive statistics and bivariate subgroup comparisons were reported. Results: All patients in both study phases received transurethral resection of the bladder tumor (TURBT). Nearly all patients reported keeping their bladder/avoiding radical cystectomy (RC) was important (99%). Results from the quantitative survey reported a substantial impact to cancer-specific HRQoL of patients, with lower mean scores on physical (64.7), social (62.8), and role functioning (56.7) as measured by the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-30). Most patients (69%) were satisfied overall with BCG treatment, although satisfaction declined with increased number of side effects, higher numbers of BCG administrations, and greater discomfort (all P < 0.05). Conclusions: Most HR-NMIBC patients were satisfied overall with BCG treatment. Approximately half of the patients had stopped BCG treatment, notably, most during the induction phase, suggesting nonadherence to guidelines which recommend maintenance treatment after induction. Future treatments should focus on delaying or avoiding recurrence and cystectomy while reducing patient discomfort and discontinuation prior to completing the recommended course of treatment.
MeSH term(s)	Humans ; Cross-Sectional Studies ; Quality of Life ; BCG Vaccine/therapeutic use ; Non-Muscle Invasive Bladder Neoplasms ; Neoplasm Staging ; Urinary Bladder Neoplasms/drug therapy ; Urinary Bladder Neoplasms/pathology ; Administration, Intravesical ; Patient Outcome Assessment ; Neoplasm Invasiveness/pathology ; Neoplasm Recurrence, Local/pathology ; Adjuvants, Immunologic/therapeutic use
Chemical Substances	BCG Vaccine ; Adjuvants, Immunologic
Language	English
Publishing date	2024-01-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	1336505-8
ISSN	1873-2496 ; 1078-1439
ISSN (online)	1873-2496
ISSN	1078-1439
DOI	10.1016/j.urolonc.2024.01.013
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Article: Cost of opioid medication abuse with and without tampering in the USA.

Vietri, Jeffrey / Masters, Elizabeth T / Barsdorf, Alexandra I / Mardekian, Jack

ClinicoEconomics and outcomes research : CEOR

2018 Volume 10, Page(s) 433–442

Abstract: Objective: To provide per-patient estimates of the economic burden for opioid medication abuse with and without tampering.: Patients and methods: Adults in the US who participated in the 2010 and/or 2011 National Health and Wellness Survey were ... ...

Abstract	Objective: To provide per-patient estimates of the economic burden for opioid medication abuse with and without tampering. Patients and methods: Adults in the US who participated in the 2010 and/or 2011 National Health and Wellness Survey were resurveyed to provide information on use and abuse of prescription opioids in the previous 3 months. Participants (N=20,885) were categorized as those who abused and tampered (n=107), abused without tampering (n=118), those who reported using of opioids as prescribed (n=981), and non-opioid controls (n=19,679). Average wages from the Bureau of Labor Statistics and health care unit costs from the Truven MarketScan database were applied to self-reported work impairment (absenteeism, presenteeism, and overall work impairment) and health care resource utilization (health care provider visits, emergency room visits, hospitalizations, and drug rehabilitation) to estimate indirect and direct medical costs, respectively. Estimated mean costs for these groups were compared using analysis of variance, and generalized linear models were used to compare costs adjusted for confounders. Results: Those who abused and tampered had significantly higher mean indirect (work impairment: $3,614 vs $2,938, Conclusion: Tampering with prescription opioid medications is associated with significantly increased medical costs compared to abuse without tampering. Reducing tampering may provide net health care savings.
Language	English
Publishing date	2018-08-10
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2520698-9
ISSN	1178-6981
ISSN	1178-6981
DOI	10.2147/CEOR.S168145
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Article ; Online: Real-world treatment patterns and outcomes in PD-L1-positive non-small cell lung cancer.

Zhang, Xinke / DeClue, Richard W / Herms, Lisa / Yang, Mo / Pawar, Vivek / Masters, Elizabeth T / Ruisi, Mary / Chin, Kevin / Velcheti, Vamsidhar

Immunotherapy

2021 Volume 13, Issue 18, Page(s) 1521–1533

Abstract: Aim: ...

Abstract	Aim:
MeSH term(s)	Aged ; B7-H1 Antigen/metabolism ; Carcinoma, Non-Small-Cell Lung/mortality ; Carcinoma, Non-Small-Cell Lung/therapy ; Disease-Free Survival ; Female ; Humans ; Lung Neoplasms/mortality ; Lung Neoplasms/therapy ; Male ; Middle Aged ; Neoplasm Proteins/metabolism ; Retrospective Studies ; Survival Rate
Chemical Substances	B7-H1 Antigen ; CD274 protein, human ; Neoplasm Proteins
Language	English
Publishing date	2021-08-04
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2495964-9
ISSN	1750-7448 ; 1750-743X
ISSN (online)	1750-7448
ISSN	1750-743X
DOI	10.2217/imt-2021-0145
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Article ; Online: The Cost-Effectiveness of Lorlatinib Versus Chemotherapy as a Second- or Third-Line Treatment in Anaplastic Lymphoma Kinase (ALK)-Positive Non-small-cell Lung Cancer in Sweden.

Nilsson, Fredrik O L / Asanin, Sandra T / Masters, Elizabeth T / Iadeluca, Laura / Almond, Chrissy / Cooper, Miranda / Smith, Sarah

PharmacoEconomics

2021 Volume 39, Issue 8, Page(s) 941–952

Abstract: Background: Lorlatinib is a third-generation anaplastic lymphoma kinase (ALK)/c-ros oncogene 1 (ROS1) tyrosine kinase inhibitor (TKI) with efficacy in patients with ALK-rearranged non-small-cell lung cancer (NSCLC) previously treated with a second- ... ...

Abstract	Background: Lorlatinib is a third-generation anaplastic lymphoma kinase (ALK)/c-ros oncogene 1 (ROS1) tyrosine kinase inhibitor (TKI) with efficacy in patients with ALK-rearranged non-small-cell lung cancer (NSCLC) previously treated with a second-generation ALK inhibitor or with first- and second-generation ALK inhibitors. We examined the cost-effectiveness of second- or third-line+ (2L+ or 3L+) lorlatinib in Sweden, versus chemotherapy. Methods: A partitioned survival model with three health states (progression free, progressed, or death) was used. Lorlatinib relative efficacy versus chemotherapy was derived using unanchored matching adjusted indirect treatment comparisons from a phase 2 clinical trial. Utility data were derived from the same trial and published studies. Costs (year 2019) were obtained from Swedish national data. Costs and benefits were discounted at 3% per annum using a societal perspective (base case). Model robustness was evaluated with deterministic and probabilistic sensitivity analyses. Results: For 2L+, the average discounted total quality-adjusted life year (QALY) gain was 1.29 years. Total incremental costs were Swedish krona (SEK) 731,791, resulting in an incremental cost-effectiveness ratio (ICER) of SEK 566,278 per QALY gained. Non-discounted survival gain amounted to 1.94 years. For 3L+, the average discounted total QALY gain was 1.25 years. Total incremental costs were SEK 754,801, resulting in an ICER of SEK 603,934 per QALY gained. Non-discounted survival gain was 1.88 years. Sensitivity analyses were consistent. Conclusions: ICERs ranged from SEK 421,000 to SEK 384,066 less than the boundary for a cost-effective treatment for a high-severity disease in Sweden (SEK 988,000), suggesting 2L+ or 3L+ lorlatinib is a cost-effective treatment for ALK-positive NSCLC versus chemotherapy.
MeSH term(s)	Aminopyridines ; Anaplastic Lymphoma Kinase/genetics ; Carcinoma, Non-Small-Cell Lung/drug therapy ; Cost-Benefit Analysis ; Humans ; Lactams ; Lung Neoplasms/drug therapy ; Lung Neoplasms/genetics ; Protein-Tyrosine Kinases ; Proto-Oncogene Proteins ; Pyrazoles ; Quality-Adjusted Life Years ; Sweden
Chemical Substances	Aminopyridines ; Lactams ; Proto-Oncogene Proteins ; Pyrazoles ; Anaplastic Lymphoma Kinase (EC 2.7.10.1) ; Protein-Tyrosine Kinases (EC 2.7.10.1) ; lorlatinib (OSP71S83EU)
Language	English
Publishing date	2021-06-03
Publishing country	New Zealand
Document type	Clinical Trial, Phase II ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1100273-6
ISSN	1179-2027 ; 1170-7690
ISSN (online)	1179-2027
ISSN	1170-7690
DOI	10.1007/s40273-021-01015-8
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Article: Humanistic and Economic Burden of Non-Muscle Invasive Bladder Cancer: Results of Two Systematic Literature Reviews.

Lee, Lauren J / Kwon, Christina S / Forsythe, Anna / Mamolo, Carla M / Masters, Elizabeth T / Jacobs, Ira A

ClinicoEconomics and outcomes research : CEOR

2020 Volume 12, Page(s) 693–709

Abstract: Purpose: Non-muscle invasive bladder cancer (NMIBC) is a malignancy restricted to the inner lining of the bladder. Intravesical Bacillus Calmette-Guerin (BCG) following transurethral resection of the bladder tumor is the mainstay first-line treatment ... ...

Abstract	Purpose: Non-muscle invasive bladder cancer (NMIBC) is a malignancy restricted to the inner lining of the bladder. Intravesical Bacillus Calmette-Guerin (BCG) following transurethral resection of the bladder tumor is the mainstay first-line treatment for high-risk NMIBC patients. Two systematic literature reviews (SLRs) were conducted to further assess the current evidence on BCG use in NMIBC and the humanistic and economic burden of disease. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, Embase Results: Fifty-nine publications were included in the HRQoL SLR, of which 23 reported HRQoL and symptoms in NMIBC. At diagnosis, HRQoL was comparable with population norms but worsened considerably 2 years following diagnosis. Maintenance therapy with intravesical BCG was associated with reduced HRQoL, and treatment-related adverse events (AEs) resembled typical NMIBC symptoms. Twenty-two studies reported decreasing BCG compliance over time. Common AEs with BCG were frequent urination, lower urinary tract symptoms, pain, and hematuria. Forty-two publications were included in the economic SLR, of which nine assessed healthcare costs and resource use in NMIBC or bladder cancer. High-risk disease and high-intensity treatment were associated with increased healthcare costs. Conclusion: NMIBC has a considerable symptomatic, HRQoL, and economic burden. Symptoms persisted and HRQoL worsened despite intravesical BCG treatment. NMIBC is a costly disease, with higher healthcare costs associated with increased risk of disease progression and recurrence. There is a high unmet need for safe and effective treatments that reduce the risk of disease progression and recurrence, provide symptomatic relief, and improve HRQoL for patients.
Language	English
Publishing date	2020-11-23
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2520698-9
ISSN	1178-6981
ISSN	1178-6981
DOI	10.2147/CEOR.S274951
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Article: Retrospective Observational Study of ALK-Inhibitor Therapy Sequencing and Outcomes in Patients with ALK-Positive Non-small Cell Lung Cancer.

Waterhouse, David M / Espirito, Janet L / Chioda, Marc D / Baidoo, Bismark / Mardekian, Jack / Robert, Nicholas J / Masters, Elizabeth T

Drugs - real world outcomes

2020 Volume 7, Issue 4, Page(s) 261–269

Abstract: Background: Data are sparse concerning the sequential use of multiple anaplastic lymphoma kinase (ALK) inhibitors for ALK-positive locally advanced or metastatic non-small cell lung cancer (NSCLC).: Objective: This study investigated sequencing and ... ...

Abstract	Background: Data are sparse concerning the sequential use of multiple anaplastic lymphoma kinase (ALK) inhibitors for ALK-positive locally advanced or metastatic non-small cell lung cancer (NSCLC). Objective: This study investigated sequencing and outcomes among patients receiving multiple ALK inhibitors. Patients and methods: This was a retrospective observational cohort study of adult patients with ALK-positive NSCLC treated with available first- and second-generation ALK inhibitors from 1 September 2011 to 31 December 2017. Duration of therapy (DOT) and overall survival (OS) were assessed with the Kaplan-Meier method. A multivariable linear regression analysis was performed to assess if DOT with a preceding ALK inhibitor was predictive of DOT for subsequent ALK inhibitor treatments. Results: A total of 410 patients were analyzed: 57% received 1 ALK inhibitor; 35%, 2 ALK inhibitors; and 8%, 3-4 ALK inhibitors. Among those receiving > 1 ALK inhibitor (n = 177), 60% received a crizotinib-led sequence and 39% an alectinib-led sequence. Nearly 60% of the overall population received chemotherapy prior to their first ALK inhibitor. Median OS for the study population was 28 months, 15 months in patients who received 1 ALK inhibitor, 42 months in patients who received 2 ALK inhibitors, and 56 months in patients who received 3-4 ALK inhibitors. Longer DOT of the first ALK inhibitor was associated with increased DOT of the second (p < 0.0001), and longer DOT of the second ALK inhibitor was associated with increased DOT of the third (p < 0.0001). Conclusions: This study provides initial information on real-world treatment patterns following the introduction of new ALK inhibitors, and supports the use of sequential ALK therapies.
Language	English
Publishing date	2020-07-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2806600-5
ISSN	2198-9788 ; 2199-1154
ISSN (online)	2198-9788
ISSN	2199-1154
DOI	10.1007/s40801-020-00207-6
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Article ; Online: Treatment Sequencing in Patients with Anaplastic Lymphoma Kinase-Positive Non-Small Cell Lung Cancer in Japan: A Real-World Observational Study.

Goto, Yasushi / Yamamoto, Nobuyuki / Masters, Elizabeth T / Kikkawa, Hironori / Mardekian, Jack / Wiltshire, Robin / Togo, Kanae / Ohe, Yuichiro

Advances in therapy

2020 Volume 37, Issue 7, Page(s) 3311–3323

Abstract: Introduction: The anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitor (TKI) alectinib was approved in Japan in 2014 for the treatment of ALK fusion gene-positive advanced non-small cell lung cancer (NSCLC). With the approvals of crizotinib in ... ...

Abstract	Introduction: The anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitor (TKI) alectinib was approved in Japan in 2014 for the treatment of ALK fusion gene-positive advanced non-small cell lung cancer (NSCLC). With the approvals of crizotinib in 2012 and ceritinib in 2017, Japan became the first country with multiple ALK TKIs available for first-line or later use in patients with ALK-positive advanced NSCLC. Here, we collected and evaluated real-world data on ALK TKI clinical usage patterns and sequencing in patients with ALK-positive NSCLC in Japan. Methods: This retrospective observational study used the Japanese Medical Data Vision database to analyze data from patients with a confirmed diagnosis of lung cancer who visited a healthcare facility in the database between April 2010 and March 2017, underwent an ALK test, received a prescription for an ALK TKI, and were at least 18 years old as of the date of the first ALK TKI prescription. There were no exclusion criteria. Descriptive analyses of demographics, baseline characteristics, ALK TKI treatment patterns and sequences, non-ALK TKI treatments received before, during, and after ALK TKI treatment, and treatment durations were reported. Results: A total of 378 patients met the inclusion criteria and were evaluated in mutually exclusive groups of patients receiving one, two, or three ALK TKIs. The initial ALK TKI prescribed was crizotinib for 52.1% of patients and alectinib for 47.9% of patients; however, the proportion of patients receiving alectinib as the initial ALK TKI increased over time following the Japanese approval of alectinib in 2014. Of the 117 patients who received two or three ALK TKIs, 106 received crizotinib as the first ALK TKI and 11 received alectinib. Before the date of the patient's first ALK TKI prescription, 153 of 378 patients (40.5%) had received chemotherapy. Of 104 patients who discontinued ALK therapy, 46.2% received chemotherapy and 5.8% received immunotherapy as their next treatment. Conclusion: At the time of this analysis, most patients who received more than one ALK TKI received crizotinib as the initial ALK TKI. Additional ALK TKIs have since been approved in Japan as first-line or later therapeutic options for patients with ALK-positive NSCLC, but the optimal sequence of ALK TKI usage remains undetermined. As new data continue to emerge, additional research will be warranted to evaluate ALK TKI sequences that do not include crizotinib as the first therapy in this patient population.
MeSH term(s)	Aged ; Anaplastic Lymphoma Kinase/antagonists & inhibitors ; Anaplastic Lymphoma Kinase/therapeutic use ; Carbazoles/therapeutic use ; Carcinoma, Non-Small-Cell Lung/drug therapy ; Carcinoma, Non-Small-Cell Lung/epidemiology ; Crizotinib/therapeutic use ; Female ; Humans ; Japan/epidemiology ; Lung Neoplasms/drug therapy ; Lung Neoplasms/epidemiology ; Male ; Middle Aged ; Piperidines/therapeutic use ; Protein Kinase Inhibitors/therapeutic use ; Pyrimidines/therapeutic use ; Receptor Protein-Tyrosine Kinases/drug effects ; Retrospective Studies ; Sulfones/therapeutic use
Chemical Substances	Carbazoles ; Piperidines ; Protein Kinase Inhibitors ; Pyrimidines ; Sulfones ; Crizotinib (53AH36668S) ; Anaplastic Lymphoma Kinase (EC 2.7.10.1) ; Receptor Protein-Tyrosine Kinases (EC 2.7.10.1) ; ceritinib (K418KG2GET) ; alectinib (LIJ4CT1Z3Y)
Language	English
Publishing date	2020-05-29
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	632651-1
ISSN	1865-8652 ; 0741-238X
ISSN (online)	1865-8652
ISSN	0741-238X
DOI	10.1007/s12325-020-01392-0
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Zs.A 2101: Show issues

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Article: Systematic review of sequencing of ALK inhibitors in

Barrows, Stephanie M / Wright, Kelly / Copley-Merriman, Catherine / Kaye, James A / Chioda, Marc / Wiltshire, Robin / Torgersen, Knut Martin / Masters, Elizabeth T

Lung Cancer (Auckland, N.Z.)

2019 Volume 10, Page(s) 11–20

Abstract: The objective of this study was to understand outcomes of patients treated with ALK inhibitors, especially when ALK inhibitors are followed by other ALK inhibitors. A systematic literature review was conducted in PubMed, Embase, and Cochrane through July ...

Abstract	The objective of this study was to understand outcomes of patients treated with ALK inhibitors, especially when ALK inhibitors are followed by other ALK inhibitors. A systematic literature review was conducted in PubMed, Embase, and Cochrane through July 17, 2017. Conference abstracts (three meetings in past 2 years) also were searched. Of 504 unique publications, 80 met inclusion criteria (47 clinical trials, 33 observational studies). Observational studies have the potential to provide information for ALK inhibitors used sequentially. Ten observational studies reported median overall survival of crizotinib-led sequences ranging from 30.3 to 63.75 months from initiation of crizotinib; 49.4-89.6 months from metastatic non-small-cell lung cancer diagnosis; and 15.5-22.0 months from initiation of the second-generation ALK inhibitor after initial crizotinib. Sequencing of ALK inhibitors may benefit patients progressing on initial ALK inhibitors.
Language	English
Publishing date	2019-02-08
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2587467-6
ISSN	1179-2728
ISSN	1179-2728
DOI	10.2147/LCTT.S179349
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Article ; Online: Natural Language Processing-Identified Problem Opioid Use and Its Associated Health Care Costs.

Masters, Elizabeth T / Ramaprasan, Arvind / Mardekian, Jack / Palmer, Roy E / Gross, David E / Cronkite, David / Von Korff, Michael / Carrell, David S

Journal of pain & palliative care pharmacotherapy

2019 Volume 32, Issue 2-3, Page(s) 106–115

Abstract: Use of prescription opioids and problems of abuse and addiction have increased over the past decade. Claims-based studies have documented substantial economic burden of opioid abuse. This study utilized electronic health record (EHR) data to identify ... ...

Abstract	Use of prescription opioids and problems of abuse and addiction have increased over the past decade. Claims-based studies have documented substantial economic burden of opioid abuse. This study utilized electronic health record (EHR) data to identify chronic opioid therapy (COT) patients with problem opioid use (POU) and compared costs with those for COT patients without POU. This study utilized EHR and claims data from an integrated health care system. Patients received COT (≥70 days' supply in ≥1 calendar quarter, 2006-2012). Natural language processing (NLP) identified notations of opioid addiction, abuse, misuse, or overuse, and manual validation was performed. Cases had evidence of POU (index = first POU notation), and controls, sampled 9:1, did not. Health care resource utilization was measured and costs estimated using Medicare reimbursement rates. A longitudinal analysis of costs was conducted using generalized estimating equations. Adjusted analyses controlled for baseline age, gender, region, specific comorbidities, and a comorbidity index. The analysis population included 1,125 cases and 10,128 controls. Unadjusted costs were higher for cases in all three years. After controlling for covariates, total costs remained higher in cases and were significantly higher in the first year of follow-up ($38,064 vs. $31,674, P = .0048). The largest cost difference was observed in the first month of follow-up. COT patients with POU experienced significantly higher costs compared with COT patients without POU in the first year of follow-up. The greatest difference in costs was observed around identification of POU.
MeSH term(s)	Adolescent ; Adult ; Aged ; Analgesics, Opioid/administration & dosage ; Analgesics, Opioid/economics ; Case-Control Studies ; Cost of Illness ; Electronic Health Records ; Female ; Follow-Up Studies ; Health Care Costs ; Humans ; Longitudinal Studies ; Male ; Medicare/economics ; Middle Aged ; Natural Language Processing ; Opioid-Related Disorders/economics ; Opioid-Related Disorders/epidemiology ; Retrospective Studies ; United States ; Young Adult
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2019-01-31
Publishing country	England
Document type	Journal Article
ZDB-ID	2078852-6
ISSN	1536-0539 ; 1536-0288
ISSN (online)	1536-0539
ISSN	1536-0288
DOI	10.1080/15360288.2018.1488794
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Article: Evaluating increased resource use in fibromyalgia using electronic health records.

Margolis, Jay M / Masters, Elizabeth T / Cappelleri, Joseph C / Smith, David M / Faulkner, Steven

ClinicoEconomics and outcomes research : CEOR

2016 Volume 8, Page(s) 675–683

Abstract: Objective: The management of fibromyalgia (FM), a chronic musculoskeletal disease, remains challenging, and patients with FM are often characterized by high health care resource utilization. This study sought to explore potential drivers of all-cause ... ...

Abstract	Objective: The management of fibromyalgia (FM), a chronic musculoskeletal disease, remains challenging, and patients with FM are often characterized by high health care resource utilization. This study sought to explore potential drivers of all-cause health care resource utilization and other factors associated with high resource use, using a large electronic health records (EHR) database to explore data from patients diagnosed with FM. Methods: This was a retrospective analysis of de-identified EHR data from the Humedica database. Adults (≥18 years) with FM were identified based on ≥2 International Classification of Diseases, Ninth Revision codes for FM (729.1) ≥30 days apart between January 1, 2008 and December 31, 2012 and were required to have evidence of ≥12 months continuous care pre- and post-index; first FM diagnosis was the index event; 12-month pre- and post-index reporting periods. Multivariable analysis evaluated relationships between variables and resource utilization. Results: Patients were predominantly female (81.4%), Caucasian (87.7%), with a mean (standard deviation) age of 54.4 (14.8) years. The highest health care resource utilization was observed for the categories of "medication orders" and "physician office visits," with 12-month post-index means of 21.2 (21.5) drug orders/patient and 15.1 (18.1) office visits/patient; the latter accounted for 73.3% of all health care visits. Opioids were the most common prescription medication, 44.3% of all patients. The chance of high resource use was significantly increased ( Conclusion: Physician office visits and pharmacotherapy orders were key drivers of all-cause health care utilization, with demographic factors, opioid use, and specific comorbidities associated with resource intensity. Health systems and providers may find their EHRs to be a useful tool for identifying and managing resource-intensive FM patients.
Language	English
Publishing date	2016-11-16
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2520698-9
ISSN	1178-6981
ISSN	1178-6981
DOI	10.2147/CEOR.S112252
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