PMID- 22507847
OWN - NLM
STAT- MEDLINE
DCOM- 20120927
LR  - 20181201
IS  - 1464-3677 (Electronic)
IS  - 1353-4505 (Linking)
VI  - 24
IP  - 3
DP  - 2012 Jun
TI  - Assessing adherence-based quality measures in epilepsy.
PG  - 293-300
LID - 10.1093/intqhc/mzs017 [doi]
AB  - OBJECTIVE: To examine the relationship of three alternative measures of adherence 
      with seven negative outcomes associated with epilepsy for development of a 
      quality measure in epilepsy. DESIGN: Retrospective cohort analysis. SETTING: 
      PharMetrics national claims database. PARTICIPANTS: Patients in the PharMetrics 
      database for the years 2004-08 taking antiepileptic drugs. INTERVENTION: None. 
      MAIN OUTCOME MEASURES: For each definition of adherence, the odds ratios (ORs) 
      comparing non-adherent with adherent groups were assessed for consistency and 
      direction for the number of hospital admissions, emergency room (ER) visits, head 
      injuries including traumatic brain injuries, falls, motor vehicle accidents 
      (MVAs), fractures and a 'seizure' outcome defined as hospital admissions or ER 
      visits with a primary diagnosis of epilepsy or convulsions. RESULTS: The 
      inclusion criteria were met by 31 635 individuals. In the multivariate analysis, 
      the adherent group had lower odds of hospital admissions with ORs for the eight 
      specifications ranging from 0.729 to 0.872 and ER visits where ORs for the eight 
      specifications ranged from 0.750 to 0.893. The eight ORs for head injuries ranged 
      from 0.647 to 0.888. For fractures, the ORs ranged from 0.407 to 0.841. Our proxy 
      for seizure was inconsistently associated with adherence status. CONCLUSIONS: All 
      the adherence measures defined non-adherent groups that were associated with 
      negative outcomes in epilepsy.
FAU - Goodman, Michael J
AU  - Goodman MJ
AD  - Department of Pharmacotherapy, Outcomes Research Center, University of Utah, Salt 
      Lake City, UT 84108, USA. michael.goodman@pharm.utah.edu
FAU - Durkin, Michael
AU  - Durkin M
FAU - Forlenza, Jamie
AU  - Forlenza J
FAU - Ye, Xiangyang
AU  - Ye X
FAU - Brixner, Diana I
AU  - Brixner DI
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120416
PL  - England
TA  - Int J Qual Health Care
JT  - International journal for quality in health care : journal of the International 
      Society for Quality in Health Care
JID - 9434628
RN  - 0 (Anticonvulsants)
RN  - 33CM23913M (Carbamazepine)
RN  - 44YRR34555 (Levetiracetam)
RN  - 6158TKW0C5 (Phenytoin)
RN  - ZH516LNZ10 (Piracetam)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Anticonvulsants/*therapeutic use
MH  - Carbamazepine/therapeutic use
MH  - Cohort Studies
MH  - Epilepsy/complications/*drug therapy
MH  - Female
MH  - Follow-Up Studies
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Levetiracetam
MH  - Male
MH  - Medication Adherence/*statistics & numerical data
MH  - Mental Disorders/etiology
MH  - Middle Aged
MH  - Odds Ratio
MH  - Phenytoin/therapeutic use
MH  - Piracetam/analogs & derivatives/therapeutic use
MH  - Quality Indicators, Health Care/*statistics & numerical data
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2012/04/18 06:00
MHDA- 2012/09/28 06:00
CRDT- 2012/04/18 06:00
PHST- 2012/04/18 06:00 [entrez]
PHST- 2012/04/18 06:00 [pubmed]
PHST- 2012/09/28 06:00 [medline]
AID - mzs017 [pii]
AID - 10.1093/intqhc/mzs017 [doi]
PST - ppublish
SO  - Int J Qual Health Care. 2012 Jun;24(3):293-300. doi: 10.1093/intqhc/mzs017. Epub 
      2012 Apr 16.