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Biological and steroid use in relationship to quality measures in older patients with inflammatory bowel disease: a US Medicare cohort study.

Johnson SL, Bartels CM, Palta M, Thorpe CT, Weiss JM, Smith MA - BMJ Open (2015)

Bottom Line: New anti-TNF use (1.4%) was associated with younger age, absence of Medicaid coverage, hospitalisation, and higher preceding use of burst (IRR=2.35, CI 1.59 to 3.47) and maintenance steroids (IRR=2.40, CI 1.05 to 5.48).Anti-TNF use was very low in this population of older patients with IBD and, importantly, was often combined with maintenance steroid use despite guidelines suggesting reduced needs.Expanding IBD-specific quality measures to include steroid taper plans may cue appropriate maintenance regimens that include anti-TNFs and other steroid sparing agents while reducing protracted concomitant steroid use as intended by current quality measures.

View Article: PubMed Central - PubMed

Affiliation: Pharmaceutical Health Services Research Department, University of Maryland School of Pharmacy, Baltimore, Maryland, USA.

No MeSH data available.


Related in: MedlinePlus

Study participation (IBD, inflammatory bowel disease; TNF, tumour necrosis factor). *Case-finding algorithm criteria are met with ≥2 claims for CD:555.xx or UC:556.xx. ***Anti-TNF contraindications are advanced CHF and malignancies as defined in online supplementary appendix 1. ***Prevalent anti-TNF users were already receiving therapy during the baseline period.
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BMJOPEN2015008597F1: Study participation (IBD, inflammatory bowel disease; TNF, tumour necrosis factor). *Case-finding algorithm criteria are met with ≥2 claims for CD:555.xx or UC:556.xx. ***Anti-TNF contraindications are advanced CHF and malignancies as defined in online supplementary appendix 1. ***Prevalent anti-TNF users were already receiving therapy during the baseline period.

Mentions: All 8502 patients were included in the descriptive analysis. Prevalent anti-TNF users were excluded from the multivariable regression analysis of new anti-TNF utilisation because the analysis was conducted to establish predictors of new anti-TNF use during the follow-up period (n=8307; figure 1).


Biological and steroid use in relationship to quality measures in older patients with inflammatory bowel disease: a US Medicare cohort study.

Johnson SL, Bartels CM, Palta M, Thorpe CT, Weiss JM, Smith MA - BMJ Open (2015)

Study participation (IBD, inflammatory bowel disease; TNF, tumour necrosis factor). *Case-finding algorithm criteria are met with ≥2 claims for CD:555.xx or UC:556.xx. ***Anti-TNF contraindications are advanced CHF and malignancies as defined in online supplementary appendix 1. ***Prevalent anti-TNF users were already receiving therapy during the baseline period.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4563221&req=5

BMJOPEN2015008597F1: Study participation (IBD, inflammatory bowel disease; TNF, tumour necrosis factor). *Case-finding algorithm criteria are met with ≥2 claims for CD:555.xx or UC:556.xx. ***Anti-TNF contraindications are advanced CHF and malignancies as defined in online supplementary appendix 1. ***Prevalent anti-TNF users were already receiving therapy during the baseline period.
Mentions: All 8502 patients were included in the descriptive analysis. Prevalent anti-TNF users were excluded from the multivariable regression analysis of new anti-TNF utilisation because the analysis was conducted to establish predictors of new anti-TNF use during the follow-up period (n=8307; figure 1).

Bottom Line: New anti-TNF use (1.4%) was associated with younger age, absence of Medicaid coverage, hospitalisation, and higher preceding use of burst (IRR=2.35, CI 1.59 to 3.47) and maintenance steroids (IRR=2.40, CI 1.05 to 5.48).Anti-TNF use was very low in this population of older patients with IBD and, importantly, was often combined with maintenance steroid use despite guidelines suggesting reduced needs.Expanding IBD-specific quality measures to include steroid taper plans may cue appropriate maintenance regimens that include anti-TNFs and other steroid sparing agents while reducing protracted concomitant steroid use as intended by current quality measures.

View Article: PubMed Central - PubMed

Affiliation: Pharmaceutical Health Services Research Department, University of Maryland School of Pharmacy, Baltimore, Maryland, USA.

No MeSH data available.


Related in: MedlinePlus