Trends in the utilisation of lipid-lowering medications in Australia: an analysis of national pharmacy claims data

Abstract Objective: To describe risk factors associated with inappropriate antibiotic prescribing to children. Design: Cross-sectional, retrospective analysis of antibiotic prescribing to children, using Kentucky Medicaid medical and pharmacy claims data, 2017. Participants: Population-based sample of pediatric Medicaid patients and providers. Methods: Antibiotic prescriptions were identified from pharmacy claims and used to describe patient and provider characteristics. Associated medical claims were identified and linked to assign diagnoses. An existing classification scheme was applied to determine appropriateness of antibiotic prescriptions. Results: Overall, 10,787 providers wrote 779,813 antibiotic prescriptions for 328,515 children insured by Kentucky Medicaid in 2017. Moreover, 154,546 (19.8%) of these antibiotic prescriptions were appropriate, 358,026 (45.9%) were potentially appropriate, 163,654 (21.0%) were inappropriate, and 103,587 (13.3%) were not associated with a diagnosis. Half of all providers wrote 12 prescriptions or less to Medicaid children. The following child characteristics were associated with inappropriate antibiotic prescribing: residence in a rural area (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.07–1.1), having a visit with an inappropriate prescriber (OR, 4.15; 95% CI, 4.1–4.2), age 0–2 years (OR, 1.39; 95% CI, 1.37–1.41), and presence of a chronic condition (OR, 1.31; 95% CI, 1.28–1.33). Conclusions: Inappropriate antibiotic prescribing to Kentucky Medicaid children is common. Provider and patient characteristics associated with inappropriate prescribing differ from those associated with higher volume. Claims data are useful to describe inappropriate use and could be a valuable metric for provider feedback reports. Policies are needed to support analysis and dissemination of antibiotic prescribing reports and should include all provider types and geographic areas.

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Abstract 275: Concomitant Statin Use With Ezetimibe Or Colesevelam For Treatment Of Hypercholesterolemia

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.6.suppl_1.a275 ◽

2013 ◽

Vol 6 (suppl_1) ◽

Author(s):

Xin Ye ◽

Harold Bays ◽

Philip Schwab

Keyword(s):

Index Date ◽

Claims Data ◽

Study Objective ◽

Factors Associated ◽

Patient Demographics ◽

Pharmacy Claims ◽

Before And After ◽

Charlson Comorbidity Score ◽

Claims Data Analysis ◽

Statin Use

OBJECTIVES: Ezetimibe or colesevelam are often used for treating hypercholesterolemia when statin therapy is insufficient or not well tolerated. Our study objective was to examine prevalence of concomitant statin use and associated factors among hypercholesterolemia patients newly treated with ezetimibe or colesevelam. METHODS: This analysis evaluated a large health plan’s Commercial and Medicare Advantage claims data from 1/1/08 to 7/31/12. The first ezetimibe (excluding fixed combination therapy of ezetimibe/simvastatin) or colesevelam prescription fill date during this period was identified as the index date. Patients were assigned to either ezetimibe or colesevelam cohort based on the index drug and were required to have ≥ 2 consecutive prescriptions for the index drug and have at least 6 months and 12 months continuous enrollment before and after the index date, respectively. Prevalence of concomitant statin use was identified based on pharmacy claims. Patient demographics and clinical characterisitics were explored to examine the factors associated with concomitant statin use using multivariate logistic regression. RESULTS: A total of 679 colesevelam and 1439 ezetimibe patients were included in this study. The concomitant use of statins was 24% among colesevelam and 50% among ezetimibe patients, respectively. After adjustment for patient demographics and comorbidities, ezetimibe patients were 3.2 times more likely than colesevelam patients to have concomitant statin use (OR= 3.168, 95% CI: 2.573, 3.900, P<0.001). Other significant factors associated with higher concomitant statin use include: male gender (OR= 1.296, 95%: 1.079, 1.558, P=0.006), presence of diabetes mellitus (OR=1.262, 95% CI: 1.035, 1.539, P=0.021) and higher Charlson comorbidity score (OR=1.114, 95% CI: 1.046, 1.187, P<0.001) CONCLUSIONS: In this claims data analysis, statins were administered along with ezetimibe more frequently than administered with colesevelam, which should be taken into account when evaluating effectiveness of ezetimibe vs. colesevelam in the real-world treatment of hypercholesterolemia.

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