PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection
Permanent URI for this collectionhttps://hdl.handle.net/20.500.11779/1928
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Article Citation - WoS: 3Citation - Scopus: 3Warfarin Discontinuation in Patientswith Unprovoked Venous Thromboembolism: a Large Us Insurance Database Analysis(Lippincott Williams & Wilkins, 2016-11-01) Mardekian, Jack; Liu, Xianchen; Phatak, Hemant; Xie, Lin; Tan, Wilson; Başer, Onur; Ramacciotti, EduardoThis study examined warfarin therapy discontinuation and its risk factors among patients with unprovoked venous thromboembolism (VTE) in the US clinical practice setting. Adult patients with unprovoked VTE were identified from the MarketScan claims database from January 1, 2006 to December 31, 2012. The index date was defined as the date of first VTE diagnosis. Patients were required to have no VTE diagnosis in the 6 months before index date and continuous health plan enrollment for 6 months before and 12 months after the index date. Warfarin discontinuation rates and adjusted hazard ratios (HRs) were reported. Of 21,163 eligible patients, 15,463 were diagnosed with deep vein thrombosis (DVT) only (73.1%), 5027 with pulmonary embolism (PE) only (23.7%), and 673 with DVT and PE (3.2%). The average duration of warfarin therapy was 5.2 months (SD = 3.0). During 1-year follow-up, 21.4% patients discontinued therapy within 3 months, 42.8% within 6 months, and 70.1% within 12 months. PE versus DVT [HR = 0.77, 95% confidence interval (CI) = 0.74-0.80], comorbid atrial fibrillation (HR = 0.73, 95% CI = 0.66-0.81), thrombophilia (HR = 0.62, 95% CI = 0.54-0.71), and age >40 years (41-65 years: HR = 0.86, 95% CI = 0.81-0.91; >65 years: HR = 0.82, 95% CI = 0.77-0.87) were significantly associated with reduced risk of warfarin discontinuation. Alcohol abuse/dependence (HR = 1.36, 95% CI = 1.20-1.55), cancer history (HR = 1.13, 95% CI = 1.07-1.19), bleeding (HR = 1.07, 95% CI = 1.01-1.15), and catheter ablation (HR = 1.10, 95% CI = 1.00-1.20) in the 6 months before index date were significantly associated with increased risk for warfarin discontinuation. In conclusion, nearly 1 of 4 patients with unprovoked VTE discontinued warfarin within 3 months. Three of 4 patients discontinued therapy within 1 year. Younger age and multiple clinical factors are associated with warfarin therapy discontinuation.Article Citation - WoS: 6Citation - Scopus: 5The Economic Impact of Symptomatic Menopause Among Low-Socioeconomic Women in the United States(Taylor & Francis Ltd, 2015-08-02) Başer, Onur; Keshishian, A; Xie, Lin; Wang, YuexiBackground: Menopausal symptoms have a significant negative impact on patient's quality of life and increase healthcare costs among women. Methods: This retrospective analysis used data from a U.S. national database (01 January 2008-31 December 2010). Patients with a diagnosis of menopause symptoms or a prescription claim for hormone therapy were matched to control patients. Healthcare resource utilization and costs during the 6-month follow-up period were compared. Generalized linear models were used to adjust for differences in baseline and demographic characteristics between the cohorts. Results: A total of 71,076 patients were included in each cohort. Patients with menopausal symptoms were more likely to have depression and anxiety and incurred significantly higher follow-up healthcare costs ($7237 vs $6739, p < 0.001) and healthcare utilization during the 6-month follow-up period. Conclusion: Patients diagnosed with menopausal symptoms or treated with hormone therapy incurred significantly higher healthcare costs than those without menopausal symptoms or treatment.