scholarly journals Association between medication adherence and non-drug healthcare utilisation and costs: a retrospective longitudinal cohort study among US women age 65 and older

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e052146
Author(s):  
Siyu Ma ◽  
Donald S Shepard ◽  
Grant A Ritter ◽  
Robert E Martell ◽  
Cindy Thomas
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Medication Adherence ◽  
Healthcare Costs ◽  
Healthcare Utilisation ◽  
Longitudinal Cohort Study ◽  
Secondary Outcome ◽  
Medicare Beneficiaries ◽  
Office Visits ◽  
Longitudinal Cohort

ObjectivesTo explore the association between hormone therapy (HT) adherence and non-drug healthcare utilisation and healthcare costs among patients with breast cancer.DesignRetrospective longitudinal cohort study.SettingThe US Medicare beneficiaries in the SEER-Medicare-linked databaseParticipantsWomen aged ≥ 65 with hormone-receptor positive breast cancer from 2007 through mid-2009 in the USA.InterventionsWe examined the relationship between HT and adherence and outcomes of our interests.Primary and secondary outcome measuresOur study cohort’s HT adherence, non-drug healthcare utilisation and healthcare costs for the first year of HT and each year, thereafter, for a total of 5 years.Results6045 eligible Medicare beneficiaries that met our selection criteria were included. We found that patients who were adherent to HT were associated with lower healthcare utilisation of all kinds (inpatient (0.35 vs 0.43, p<0.001), length of study during hospitalisation (4.19 vs 4.89, p<0.01), physician office visits (25.16 vs 26.17, p<0.001)), and significant reductions in many types of medical costs and neutral total healthcare costs despite the increased pharmacy costs. Half of the total medical cost reduction came from savings in hospitalisation costs.ConclusionsOur study suggests that the added cost of HT adherence was all but offset by the reduced cost for other medical care. Our study provides evidence on the potential success of implementing value-based insurance design (VBID) plans among patients with breast cancer to improve their long-term oral medication adherence. Policymakers should consider adherence improvement strategies such as VBID plans, given that the costs likely will not surpass the total savings.

scholarly journals Breast cancer among shift workers: results of the WOLF longitudinal cohort study

2012 ◽  
Vol 39 (2) ◽  
pp. 170-177 ◽  
Author(s):  
Anders Knutsson ◽  
Lars Alfredsson ◽  
Berndt Karlsson ◽  
Torbjörn Åkerstedt ◽  
Eleonor I Fransson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Longitudinal Cohort Study ◽  
Shift Workers ◽  
Longitudinal Cohort

Insomnia and Fatigue Symptom Trajectories in Breast Cancer: A Longitudinal Cohort Study

2021 ◽  
pp. 1-14
Author(s):  
Helena R. Bean ◽  
Justine Diggens ◽  
Maria Ftanou ◽  
Karen L. Weihs ◽  
Annette L. Stanton ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Longitudinal Cohort Study ◽  
Longitudinal Cohort ◽  
Symptom Trajectories

scholarly journals Sociodemographic and disease-related determinants of return to work among women with breast cancer: a German longitudinal cohort study

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Christian Heuser ◽  
Sarah Halbach ◽  
Christoph Kowalski ◽  
Anna Enders ◽  
Holger Pfaff ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Return To Work ◽  
Longitudinal Cohort Study ◽  
Longitudinal Cohort

scholarly journals Childhood MMR vaccination and the incidence rate of measles infection: a ten year longitudinal cohort study of American children born in the 1990s

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
David A. Geier ◽  
Janet K. Kern ◽  
Mark R. Geier
Keyword(s):  
Cohort Study ◽  
Incidence Rate ◽  
The United States ◽  
Cox Proportional Hazards ◽  
Longitudinal Cohort Study ◽  
Research Database ◽  
Office Visits ◽  
Mmr Vaccine ◽  
Longitudinal Cohort ◽  
American Children

Abstract Background Measles (rubeola) is a highly contagious disease with significant morbidity/mortality. Measles-Mumps-Rubella (MMR) is a live-attenuated vaccine used in the United States (US) since the early 1970s to prevent measles infection. This retrospective longitudinal cohort study examined childhood MMR vaccination effectiveness (VE) on preventing diagnosed measles cases. Methods The Independent Healthcare Research Database (IHRD) is composed of non-identifiable linked eligibility and claim healthcare records prospectively generated from the Florida Medicaid system. The SAS system was utilized to examine a cohort of 101,736 persons eligible for Florida Medicaid from 1990 to 2009 and continuously eligible with ≥10 outpatient office visits during the 120-month period following birth. There were 32,870 persons (224,492 person-years) in the cohort receiving a single dose of childhood MMR vaccine (vaccinated) and 43,538 persons (434,637 person-years) in an unvaccinated cohort (no exposures to measles-containing vaccine). The frequency of diagnosed measles (ICD-9 code: 055xxx) was examined. Cox proportional hazards models evaluated MMR vaccination and diagnosed measles over time. Results MMR vaccinated cohort members were at significantly reduced risk of measles in the unadjusted (VE = 83.6, 95% CI = 67.2–91.8%) and adjusted (VE = 80.7, 95% CI = 61.5–83.9%) models as compared to the unvaccinated cohort. VE = 80% among younger MMR recipients (12–15 months), whereas VE = 90% among older MMR recipients (16–20 months) as compared to the unvaccinated cohort. Conclusion Routine childhood MMR vaccination significantly reduced the incidence rate of childhood measles infections, and the VE was greater in the older recipients (16–20 months) than in the younger recipients (12–15 months).

scholarly journals Medical cannabis authorization and the risk of cardiovascular events: a longitudinal cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Arsene Zongo ◽  
Cerina Lee ◽  
Jason R. B. Dyck ◽  
Jihane El-Mourad ◽  
Elaine Hyshka ◽  
...  
Keyword(s):  
Cohort Study ◽  
Proportional Hazards ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Longitudinal Cohort Study ◽  
Secondary Outcome ◽  
Medical Cannabis ◽  
Longitudinal Cohort ◽  
Coronary Syndrome ◽  
Increased Risk

Abstract Background Cannabis is increasingly used for therapeutic purpose. However, its safety profile is not well known. This study assessed the risk of cardiovascular-related emergency department (ED) visit and hospitalization in adult patients authorized to use medical cannabis in Ontario, Canada from 2014 to 2017. Methods This is a longitudinal cohort study of patients who received medical cannabis authorization and followed-up in cannabis clinics, matched to population-based controls. The primary outcome was an ED visit or hospitalization for acute coronary syndrome (ACS) or stroke; and secondary outcome was for any cardiovascular event. Conditional Cox proportional hazards regression was used to assess the association between cannabis authorization and risk. Results 18,653 cannabis patients were matched to 51,243 controls. During a median follow-up of 242 days, the incidence rates for ACS or stroke were 7.19/1000 person-years and 5.67/1000 person-years in the cannabis and controls group, respectively- adjusted hazard ratio (aHR) of 1.44 (95% CI 1.08–1.93). When stratified by sex, the association was only statistically significant among males: aHR 1.77 (1.23–2.56). For the secondary outcome (any CV events), the aHR was 1.47 (1.26–1.72). The aHR among males and females were 1.52 (1.24–1.86) and 1.41 (1.11–1.79), respectively. Tested interaction between cannabis authorization and sex was not significant (p > 0.05). Conclusions Medical cannabis authorization was associated with an increased risk of ED visits or hospitalization for CV events including stroke and ACS.

scholarly journals Factors of non-responsive or lost-to-follow-up Japanese mothers during the first year post partum following the Japan Environment and Children’s Study: a longitudinal cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031222 ◽  
Author(s):  
Mika Kigawa ◽  
Akiko Tsuchida ◽  
Kenta Matsumura ◽  
Ayako Takamori ◽  
Mika Ito ◽  
...  
Keyword(s):  
Cohort Study ◽  
Health Status ◽  
Longitudinal Cohort Study ◽  
Secondary Outcome ◽  
Baseline Survey ◽  
First Year ◽  
Longitudinal Cohort ◽  
Physical Conditions ◽  
Lost To Follow Up

ObjectivesWe examined the factors related to lost-to-follow-up of a birth cohort study during the first year after delivery.DesignLongitudinal cohort study.SettingQuestionnaires were provided by mail. Mothers answered the questionnaires about the children twice: at 6 months and 1 year.ParticipantsOf 103 062 pregnancies who consented to participate in the Japan Environment and Children’s Study (JECS), 93 417 mothers were included in the study after excluding those with multiple births, miscarriages or stillbirths and those who withdrew from the study within 1 year after providing informed consent.Primary and secondary outcome measuresParticipants’ socioeconomic status, medical history, health status, health-related behaviours, their children’s health conditions and living situations were collected by self-administered questionnaires during pregnancy or 1 month after delivery as the baseline survey. In addition, two self-administered questionnaires were distributed 6 months and 1 year after delivery. Using the response status of the two questionnaires after delivery, participants’ follow-up status was divided into four groups. The related factors were examined using logistic regression analysis.ResultsFactors positively correlated with lost-to-follow-up to the questionnaires were postpartum physical conditions, psychological distress during pregnancy, the child’s health status at birth, the child’s primary caregiver and the number of siblings of the child. Partners’ active participation in JECS was associated with a lower lost-to-follow-up rate to the two questionnaires, whereas inactive participation was positively associated with a higher lost-to-follow-up rate.ConclusionThe response rate to the questionnaires seems to be related to the interest and understanding of participants’ partners. In addition, the response rates are related to participants’ physical conditions and living conditions. To decrease lost-to-follow-up rates in consecutive questionnaire surveys within a cohort study, it may be important for investigators to recognise that participants and their motivation in research can be influenced by perceptions they may have regarding the objectives of the research.

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