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Utilization of statins and impact of...

Ye, Xin.

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Utilization of statins and impact of compliance on health and economic outcomes in coronary heart disease patients.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Utilization of statins and impact of compliance on health and economic outcomes in coronary heart disease patients./
作者:	Ye, Xin.
面頁冊數:	160 p.
附註:	Source: Dissertation Abstracts International, Volume: 66-06, Section: B, page: 3085.
Contained By:	Dissertation Abstracts International66-06B.
標題:	Health Sciences, Pharmacy. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3180037
ISBN:	9780542203169

Utilization of statins and impact of compliance on health and economic outcomes in coronary heart disease patients.
Ye, Xin.

Utilization of statins and impact of compliance on health and economic outcomes in coronary heart disease patients. - 160 p.

Source: Dissertation Abstracts International, Volume: 66-06, Section: B, page: 3085.

Thesis (Ph.D.)--University of Minnesota, 2005.

The primary objectives of this study were to: (1) examine the pattern of statin initiation after hospital discharge for coronary heart disease (CHD), and to identify factors affecting statin initiation; (2) investigate the factors associated with compliance to statins in patients who start statin use after discharge from a CHD hospitalization; (3) estimate the impact of compliance to statins on health outcomes of CHD patients and on related economic costs.

ISBN: 9780542203169Subjects--Topical Terms:

1017737
Health Sciences, Pharmacy.

Utilization of statins and impact of compliance on health and economic outcomes in coronary heart disease patients.
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245 1 0 $a Utilization of statins and impact of compliance on health and economic outcomes in coronary heart disease patients.
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500 $a Source: Dissertation Abstracts International, Volume: 66-06, Section: B, page: 3085.
500 $a Advisers: Cynthia R. Gross; Wendy L. St. Peter.
502 $a Thesis (Ph.D.)--University of Minnesota, 2005.
520 $a The primary objectives of this study were to: (1) examine the pattern of statin initiation after hospital discharge for coronary heart disease (CHD), and to identify factors affecting statin initiation; (2) investigate the factors associated with compliance to statins in patients who start statin use after discharge from a CHD hospitalization; (3) estimate the impact of compliance to statins on health outcomes of CHD patients and on related economic costs.
520 $a This study employed a retrospective cohort design. 1999--2003 MedStat MarketScanRTM Databases were utilized for the analyses. Andersen's health services utilization model was the conceptual framework adopted to guide selection of potentially important factors influencing statin utilization. Propensity score methodology was applied to control for possible selection biases between complaint patients and non-compliant patients in the analysis of outcomes. To analyze medical costs with incomplete follow-up information, weighted regression models were used to account for censoring.
520 $a Fewer than half of the study subjects initiated statin therapy within 6 months after hospital discharge for CHD. Age, gender, dyslipidemia, psychoses, comorbidity index score, non-statin lipid lowering drugs (LLDs) use, beta-blocker use, CHD type, enrollee type, year of CHD hospitalization, co-payment, health plan type, region and cardiologist visit were significantly associated with initiation of statins. Of those who initiated statin therapy, about 60% were compliant, defined as having a medication possession ratio of 80% or more within the year after the initiation. Compliance to statins was associated with age, gender, region, dyslipidemia, depression, concomitant use of LLDs and beta-blockers, CHD type, length of hospital stay, and co-payment. Patients who were non-compliant to statins were about 30% and 20% more likely to experience a subsequent CHD or all-cause hospitalization, respectively, There was no significant difference in subsequent total health care costs between compliant and non-compliant patients; compliant patients had significantly lower medical costs, but higher prescription drug costs.
520 $a Overall, use of statins in these patients was sub-optimal. Compliance to statins after CHD hospitalization was significantly associated with lower risk of experiencing a subsequent hospitalization, an important quality of life consideration, but was not associated with a significant saving in total health care costs.
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773 0 $t Dissertation Abstracts International $g 66-06B.
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790 1 0 $a St. Peter, Wendy L., $e advisor
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