Hydroxyurea adherence and associated outcomes among Medicaid enrollees with sickle cell disease
dc.contributor.author | Candrilli, Sean D. | en_US |
dc.contributor.author | O'Brien, Sarah H. | en_US |
dc.contributor.author | Ware, Russell E. | en_US |
dc.contributor.author | Nahata, Milap C. | en_US |
dc.contributor.author | Seiber, Eric E. | en_US |
dc.contributor.author | Balkrishnan, Rajesh R. | en_US |
dc.date.accessioned | 2011-03-10T16:03:08Z | |
dc.date.accessioned | 2011-03-10T16:03:08Z | |
dc.date.available | 2012-04-30T18:27:22Z | en_US |
dc.date.issued | 2011-03 | en_US |
dc.identifier.citation | Candrilli, Sean D.; O'Brien, Sarah H.; Ware, Russell E.; Nahata, Milap C.; Seiber, Eric E.; Balkrishnan, Rajesh (2011). "Hydroxyurea adherence and associated outcomes among Medicaid enrollees with sickle cell disease." American Journal of Hematology 86(3): 273-277. <http://hdl.handle.net/2027.42/83190> | en_US |
dc.identifier.issn | 0361-8609 | en_US |
dc.identifier.issn | 1096-8652 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/83190 | |
dc.description.abstract | While laboratory and clinical benefits of hydroxyurea for patients with sickle cell disease (SCD) are well-established, few data describe the extent and implications of non-adherence. We sought to assess adherence to hydroxyurea among patients with SCD and investigate associations between adherence and clinical and economic outcomes. Insurance claims of North Carolina Medicaid enrollees (6/2000-8/2008) with SCD were analyzed. Inclusion criteria included age <65 years, continuous Medicaid enrollment ≥12 months before and following hydroxyurea initiation, and ≥2 hydroxyurea prescriptions. Three hundred twelve patients, mean age 21 (±12.2) years, met inclusion criteria and 35% were adherent, defined as a medication possession ration (MPR) ≥ 0.80; mean MPR was 0.60. In the 12 months following hydroxyurea initiation, adherence was associated with reduced risk of SCD-related hospitalization (hazard ratio [HR] = 0.65, p = .0351), all-cause and SCD-related emergency department visit (HR = 0.72, p = .0388; HR = 0.58, p =.0079, respectively), and vaso-occlusive event (HR = 0.66, p = .0130). Adherence was associated with reductions in health care costs such as all-cause and SCD-related inpatient (−$5,286, p < .0001; −$4,403, p < .0001, respectively), ancillary care (−$1,336, p < .0001; −$836, p < .0001, respectively), vaso-occlusive event-related (−$5,793, p < .0001), and total costs (−$6,529, p < .0001; −$5,329, p <.0001, respectively). Adherence to hydroxyurea among SCD patients appears suboptimal and better adherence is associated with improved clinical and economic outcomes. Am. J. Hematol. 2011. © 2010 Wiley-Liss, Inc. | en_US |
dc.publisher | Wiley Subscription Services, Inc., A Wiley Company | en_US |
dc.subject.other | Life and Medical Sciences | en_US |
dc.subject.other | Cancer Research, Oncology and Pathology | en_US |
dc.title | Hydroxyurea adherence and associated outcomes among Medicaid enrollees with sickle cell disease | en_US |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | en_US |
dc.subject.hlbsecondlevel | Molecular, Cellular and Developmental Biology | en_US |
dc.subject.hlbsecondlevel | Oncology and Hematology | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.subject.hlbtoplevel | Science | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Department of Clinical, Social and Administrative Pharmacy, School of Pharmacy, The University of Michigan, Ann Arbor, Michigan ; Department of Health Policy and Management, School of Public Health, The University of Michigan, Ann Arbor, Michigan | en_US |
dc.contributor.affiliationother | RTI Health Solutions, Research Triangle Park, North Carolina ; Department of Pharmacy Administration and Policy, College of Pharmacy, The Ohio State University, Columbus, Ohio ; S.D.C. and S.H.O. contributed equally to this work. | en_US |
dc.contributor.affiliationother | Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio ; Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, Columbus, OH | en_US |
dc.contributor.affiliationother | Department of Hematology, St. Jude Children's Research Hospital, Memphis, Tennessee | en_US |
dc.contributor.affiliationother | Division of Pharmacy Practice and Administration, College of Pharmacy, The Ohio State University, Columbus, Ohio | en_US |
dc.contributor.affiliationother | Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, Ohio | en_US |
dc.identifier.pmid | 21328441 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/83190/1/21968_ftp.pdf | |
dc.identifier.doi | 10.1002/ajh.21968 | en_US |
dc.identifier.source | American Journal of Hematology | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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