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Descriptive analysis of real-world medication use pattern of statins and antiplatelet agents among patients with acute coronary syndrome in Hong Kong and the USA
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| Zeitschriftentitel: | BMJ Open |
|---|---|
| Personen und Körperschaften: | , , , , , |
| In: | BMJ Open, 9, 2019, 7, S. e024937 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
BMJ
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| Schlagwörter: |
| author_facet |
Wang, Yun Nichol, Michael B Yan, Bryan PY Wu, Joanne Tomlinson, Brian Lee, Vivian WY Wang, Yun Nichol, Michael B Yan, Bryan PY Wu, Joanne Tomlinson, Brian Lee, Vivian WY |
|---|---|
| author |
Wang, Yun Nichol, Michael B Yan, Bryan PY Wu, Joanne Tomlinson, Brian Lee, Vivian WY |
| spellingShingle |
Wang, Yun Nichol, Michael B Yan, Bryan PY Wu, Joanne Tomlinson, Brian Lee, Vivian WY BMJ Open Descriptive analysis of real-world medication use pattern of statins and antiplatelet agents among patients with acute coronary syndrome in Hong Kong and the USA General Medicine |
| author_sort |
wang, yun |
| spelling |
Wang, Yun Nichol, Michael B Yan, Bryan PY Wu, Joanne Tomlinson, Brian Lee, Vivian WY 2044-6055 2044-6055 BMJ General Medicine http://dx.doi.org/10.1136/bmjopen-2018-024937 <jats:sec><jats:title>Objectives</jats:title><jats:p>The objective was to explore the differences in medication use pattern of lipid-lowering drug (LLD) and antiplatelet agents among post-percutaneous coronary intervention patients with acute coronary syndrome aged <65 in Hong Kong (HK) and the USA.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Retrospective study.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>This study used deidentified claims data from Clinformatics Data Mart database (OptumInsight, Eden Prairie, Minnesota, USA) and electronic health records from HK Hospital Authority Clinical Data Analysis and Reporting System database.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>We used 1 year prescription records of LLDs and antiplatelet agents among 1013 USA patients and 270 HK Chinese patients in 2011–2013.</jats:p></jats:sec><jats:sec><jats:title>Primary and secondary outcome measures</jats:title><jats:p>Continuity was investigated on the assumption that one defined daily dose represented 1 day treatment. Medication possession ratio method was used to evaluate the adherence. Multivariate-adjusted logistic regressions were constructed to compare the good continuity and adherence levels in the merged database with the cutoffs set at 80%, and Cox proportional hazard models were built using the time to discontinuation as the dependent variable, to assess the persistence level.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>HK Chinese patients were less adherent (67.41% vs 84.60%, adjusted odds ratio (AOR) for Americans over Chinese=2.23 (95% CI=1.60 to 3.12), p<0.001) to antiplatelet agents compared with American patients but better adherent to statins (90.00% vs 78.18%, AOR=0.37 (0.23 to 0.58), p<0.001). The discontinuation with statins was more common in American patients (13.33% vs 34.25%, adjusted hazard ratio (AHR)=2.95 (2.05 to 4.24), p<0.001). Low-to-moderate potency statins and clopidogrel were favoured by our HK local physicians, while American patients received higher doses of statins and prasugrel.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>We seemed to find HK physicians tended to prescribe cheaper and lower doses of statins and antiplatelet agents when compared with the privately insured patients in the USA, though the adherence and persistence levels of HK patients with statins were relatively good.</jats:p></jats:sec> Descriptive analysis of real-world medication use pattern of statins and antiplatelet agents among patients with acute coronary syndrome in Hong Kong and the USA BMJ Open |
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| title |
Descriptive analysis of real-world medication use pattern of statins and antiplatelet agents among patients with acute coronary syndrome in Hong Kong and the USA |
| title_unstemmed |
Descriptive analysis of real-world medication use pattern of statins and antiplatelet agents among patients with acute coronary syndrome in Hong Kong and the USA |
| title_full |
Descriptive analysis of real-world medication use pattern of statins and antiplatelet agents among patients with acute coronary syndrome in Hong Kong and the USA |
| title_fullStr |
Descriptive analysis of real-world medication use pattern of statins and antiplatelet agents among patients with acute coronary syndrome in Hong Kong and the USA |
| title_full_unstemmed |
Descriptive analysis of real-world medication use pattern of statins and antiplatelet agents among patients with acute coronary syndrome in Hong Kong and the USA |
| title_short |
Descriptive analysis of real-world medication use pattern of statins and antiplatelet agents among patients with acute coronary syndrome in Hong Kong and the USA |
| title_sort |
descriptive analysis of real-world medication use pattern of statins and antiplatelet agents among patients with acute coronary syndrome in hong kong and the usa |
| topic |
General Medicine |
| url |
http://dx.doi.org/10.1136/bmjopen-2018-024937 |
| publishDate |
2019 |
| physical |
e024937 |
| description |
<jats:sec><jats:title>Objectives</jats:title><jats:p>The objective was to explore the differences in medication use pattern of lipid-lowering drug (LLD) and antiplatelet agents among post-percutaneous coronary intervention patients with acute coronary syndrome aged <65 in Hong Kong (HK) and the USA.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Retrospective study.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>This study used deidentified claims data from Clinformatics Data Mart database (OptumInsight, Eden Prairie, Minnesota, USA) and electronic health records from HK Hospital Authority Clinical Data Analysis and Reporting System database.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>We used 1 year prescription records of LLDs and antiplatelet agents among 1013 USA patients and 270 HK Chinese patients in 2011–2013.</jats:p></jats:sec><jats:sec><jats:title>Primary and secondary outcome measures</jats:title><jats:p>Continuity was investigated on the assumption that one defined daily dose represented 1 day treatment. Medication possession ratio method was used to evaluate the adherence. Multivariate-adjusted logistic regressions were constructed to compare the good continuity and adherence levels in the merged database with the cutoffs set at 80%, and Cox proportional hazard models were built using the time to discontinuation as the dependent variable, to assess the persistence level.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>HK Chinese patients were less adherent (67.41% vs 84.60%, adjusted odds ratio (AOR) for Americans over Chinese=2.23 (95% CI=1.60 to 3.12), p<0.001) to antiplatelet agents compared with American patients but better adherent to statins (90.00% vs 78.18%, AOR=0.37 (0.23 to 0.58), p<0.001). The discontinuation with statins was more common in American patients (13.33% vs 34.25%, adjusted hazard ratio (AHR)=2.95 (2.05 to 4.24), p<0.001). Low-to-moderate potency statins and clopidogrel were favoured by our HK local physicians, while American patients received higher doses of statins and prasugrel.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>We seemed to find HK physicians tended to prescribe cheaper and lower doses of statins and antiplatelet agents when compared with the privately insured patients in the USA, though the adherence and persistence levels of HK patients with statins were relatively good.</jats:p></jats:sec> |
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| author | Wang, Yun, Nichol, Michael B, Yan, Bryan PY, Wu, Joanne, Tomlinson, Brian, Lee, Vivian WY |
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| description | <jats:sec><jats:title>Objectives</jats:title><jats:p>The objective was to explore the differences in medication use pattern of lipid-lowering drug (LLD) and antiplatelet agents among post-percutaneous coronary intervention patients with acute coronary syndrome aged <65 in Hong Kong (HK) and the USA.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Retrospective study.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>This study used deidentified claims data from Clinformatics Data Mart database (OptumInsight, Eden Prairie, Minnesota, USA) and electronic health records from HK Hospital Authority Clinical Data Analysis and Reporting System database.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>We used 1 year prescription records of LLDs and antiplatelet agents among 1013 USA patients and 270 HK Chinese patients in 2011–2013.</jats:p></jats:sec><jats:sec><jats:title>Primary and secondary outcome measures</jats:title><jats:p>Continuity was investigated on the assumption that one defined daily dose represented 1 day treatment. Medication possession ratio method was used to evaluate the adherence. Multivariate-adjusted logistic regressions were constructed to compare the good continuity and adherence levels in the merged database with the cutoffs set at 80%, and Cox proportional hazard models were built using the time to discontinuation as the dependent variable, to assess the persistence level.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>HK Chinese patients were less adherent (67.41% vs 84.60%, adjusted odds ratio (AOR) for Americans over Chinese=2.23 (95% CI=1.60 to 3.12), p<0.001) to antiplatelet agents compared with American patients but better adherent to statins (90.00% vs 78.18%, AOR=0.37 (0.23 to 0.58), p<0.001). The discontinuation with statins was more common in American patients (13.33% vs 34.25%, adjusted hazard ratio (AHR)=2.95 (2.05 to 4.24), p<0.001). Low-to-moderate potency statins and clopidogrel were favoured by our HK local physicians, while American patients received higher doses of statins and prasugrel.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>We seemed to find HK physicians tended to prescribe cheaper and lower doses of statins and antiplatelet agents when compared with the privately insured patients in the USA, though the adherence and persistence levels of HK patients with statins were relatively good.</jats:p></jats:sec> |
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| spelling | Wang, Yun Nichol, Michael B Yan, Bryan PY Wu, Joanne Tomlinson, Brian Lee, Vivian WY 2044-6055 2044-6055 BMJ General Medicine http://dx.doi.org/10.1136/bmjopen-2018-024937 <jats:sec><jats:title>Objectives</jats:title><jats:p>The objective was to explore the differences in medication use pattern of lipid-lowering drug (LLD) and antiplatelet agents among post-percutaneous coronary intervention patients with acute coronary syndrome aged <65 in Hong Kong (HK) and the USA.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Retrospective study.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>This study used deidentified claims data from Clinformatics Data Mart database (OptumInsight, Eden Prairie, Minnesota, USA) and electronic health records from HK Hospital Authority Clinical Data Analysis and Reporting System database.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>We used 1 year prescription records of LLDs and antiplatelet agents among 1013 USA patients and 270 HK Chinese patients in 2011–2013.</jats:p></jats:sec><jats:sec><jats:title>Primary and secondary outcome measures</jats:title><jats:p>Continuity was investigated on the assumption that one defined daily dose represented 1 day treatment. Medication possession ratio method was used to evaluate the adherence. Multivariate-adjusted logistic regressions were constructed to compare the good continuity and adherence levels in the merged database with the cutoffs set at 80%, and Cox proportional hazard models were built using the time to discontinuation as the dependent variable, to assess the persistence level.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>HK Chinese patients were less adherent (67.41% vs 84.60%, adjusted odds ratio (AOR) for Americans over Chinese=2.23 (95% CI=1.60 to 3.12), p<0.001) to antiplatelet agents compared with American patients but better adherent to statins (90.00% vs 78.18%, AOR=0.37 (0.23 to 0.58), p<0.001). The discontinuation with statins was more common in American patients (13.33% vs 34.25%, adjusted hazard ratio (AHR)=2.95 (2.05 to 4.24), p<0.001). Low-to-moderate potency statins and clopidogrel were favoured by our HK local physicians, while American patients received higher doses of statins and prasugrel.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>We seemed to find HK physicians tended to prescribe cheaper and lower doses of statins and antiplatelet agents when compared with the privately insured patients in the USA, though the adherence and persistence levels of HK patients with statins were relatively good.</jats:p></jats:sec> Descriptive analysis of real-world medication use pattern of statins and antiplatelet agents among patients with acute coronary syndrome in Hong Kong and the USA BMJ Open |
| spellingShingle | Wang, Yun, Nichol, Michael B, Yan, Bryan PY, Wu, Joanne, Tomlinson, Brian, Lee, Vivian WY, BMJ Open, Descriptive analysis of real-world medication use pattern of statins and antiplatelet agents among patients with acute coronary syndrome in Hong Kong and the USA, General Medicine |
| title | Descriptive analysis of real-world medication use pattern of statins and antiplatelet agents among patients with acute coronary syndrome in Hong Kong and the USA |
| title_full | Descriptive analysis of real-world medication use pattern of statins and antiplatelet agents among patients with acute coronary syndrome in Hong Kong and the USA |
| title_fullStr | Descriptive analysis of real-world medication use pattern of statins and antiplatelet agents among patients with acute coronary syndrome in Hong Kong and the USA |
| title_full_unstemmed | Descriptive analysis of real-world medication use pattern of statins and antiplatelet agents among patients with acute coronary syndrome in Hong Kong and the USA |
| title_short | Descriptive analysis of real-world medication use pattern of statins and antiplatelet agents among patients with acute coronary syndrome in Hong Kong and the USA |
| title_sort | descriptive analysis of real-world medication use pattern of statins and antiplatelet agents among patients with acute coronary syndrome in hong kong and the usa |
| title_unstemmed | Descriptive analysis of real-world medication use pattern of statins and antiplatelet agents among patients with acute coronary syndrome in Hong Kong and the USA |
| topic | General Medicine |
| url | http://dx.doi.org/10.1136/bmjopen-2018-024937 |