scholarly journals Evaluating the Impact of CYP3A5 Genotype on Post-Transplant Healthcare Resource Utilization in Pediatric Renal and Heart Transplant Recipients Receiving Tacrolimus

2021 ◽  
Vol Volume 14 ◽  
pp. 319-326
Author(s):  
Amy L Pasternak ◽  
Vincent D Marshall ◽  
Christina L Gersch ◽  
James M Rae ◽  
Michael Englesbe ◽  
...  
Keyword(s):  
Resource Utilization ◽  
Heart Transplant ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Transplant Recipients ◽  
Post Transplant ◽  
Cyp3a5 Genotype ◽  
Heart Transplant Recipients ◽  
The Impact

Abstract 2891: Reversible Pulmonary Hypertension has Comparable Survival - Analysis of 10331 Heart Transplant Recipients in Recent Era

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Lois U Nwakanma ◽  
Eric S Weiss ◽  
Nishant D Patel ◽  
William A Baumgartner ◽  
Stuart D Russell ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Heart Transplant ◽  
Cox Regression ◽  
Transplant Recipients ◽  
Cox Regression Analysis ◽  
Post Transplant ◽  
Fixed Group ◽  
Number Of Patients ◽  
Heart Transplant Recipients ◽  
The Impact

Background: Conflicting data exist regarding the impact of reversible pulmonary hypertension (PHTN) on post-transplant outcomes. We sought to determine how reversible PHTN affects survival in a large cohort of heart transplant recipients. Methods: A retrospective cohort study of United Network for Organ Sharing (UNOS) data from January 1, 2000 to December 31, 2006 was performed. Based on the amount of pulmonary vascular resistance (PVR) at initial listing and the most recent PVR prior to transplant, patients were stratified into 3 groups (Normal -PVR always < 2.5 Wood units, Reversible - PVR initially > 2.5, but < 2.5 prior to transplant, Fixed - PVR always > 2.5) and survival post transplant was analyzed. Results: Data was available on 10331 recipients. Of those patients, 3886 (37.6%) patients were classified as Normal, 1621 (15.7%) were Reversible, and 4824 (46.7%) had Fixed PHTN. Among the fixed group, PHTN was severe in 1989 patients (PVR >=5). Kaplan-Meier survival was comparable by log rank test between the normal and reversible groups (p>0.05) but was significantly worse for the fixed group (p<0.001). Sub-analysis of patients with initial PVR>=5 in the reversible group also had comparable survival to the normal group. These survival results were confirmed in a propensity-adjusted multivariate Cox regression analysis, controlling for clinically relevant co-founders. Furthermore, similar results were obtained using PVR of 2.5 or 5 as the cut-off points. Conclusions: The UNOS database has provided the largest number of patients analyzed by PVR. Reversible pulmonary hypertension has comparable post-transplant survival regardless of initial severity.

scholarly journals Healthcare resource utilization and associated cost of patients with bone metastases from solid tumors who are naïve to bone-targeting agents: a comparative analysis of patients with and without skeletal-related events

2021 ◽  
Vol 22 (2) ◽  
pp. 243-254
Author(s):  
Fränce Hardtstock ◽  
Zeki Kocaata ◽  
Thomas Wilke ◽  
Axel Dittmar ◽  
Marco Ghiani ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Solid Tumors ◽  
Resource Utilization ◽  
Inpatient Care ◽  
Healthcare Resource ◽  
Cohort Analysis ◽  
Healthcare Resource Utilization ◽  
Bone Targeting ◽  
Skeletal Related Events ◽  
The Impact

Abstract Background This study analyzes the impact of skeletal-related events (SRE) on healthcare resource utilization (HCRU) and costs incurred by patients with bone metastases (BM) from solid tumors (ST), who are therapy-naïve to bone targeting agents (BTAs). Methods German claims data from 01/01/2010 to 30/06/2018 were used to conduct a retrospective comparative cohort analysis of BTA-naive patients with a BM diagnosis and preceding ST diagnosis. HCRU and treatment-related costs were compared in two matched cohorts of patients with and without a history of SREs, defined as pathological fracture, spinal cord compression, surgery to bone and radiation to bone. The first SRE was defined as the patient-individual index date. Conversely, for the non-SRE patients, index dates were assigned randomly. Results In total, 45.20% of 9,832 patients reported experiencing at least one SRE (n = 4444) while 54.80% experienced none (n = 5388); 2,434 pairs of SRE and non-SRE patients were finally matched (mean age: 70.87/71.07 years; females: 39.07%/38.58%). Between SRE and non-SRE cohorts, significant differences in the average number of hospitalization days per patient-year (35.80/30.80) and associated inpatient-care costs (14,199.27€/10,787.31€) were observed. The total cost ratio was 1.16 (p < 0.001) with an average cost breakdown of 23,689.54€ and 20,403.27€ per patient-year in SRE and non-SRE patients. Conclusion The underutilization of BTAs within a clinical setting poses an ongoing challenge in the real-world treatment of BM patients throughout Germany. Ultimately, the economic burden of treating SREs in patients with BM from ST was found to be considerable, resulting in higher direct healthcare costs and increased utilization of inpatient care facilities.

Onset, timing and risk for depression and anxiety in family caregivers to heart transplant recipients

2004 ◽  
Vol 34 (6) ◽  
pp. 1065-1082 ◽  
Author(s):  
MARY AMANDA DEW ◽  
LARISSA MYASKOVSKY ◽  
ANDREA F. DIMARTINI ◽  
GALEN E. SWITZER ◽  
HERBERT C. SCHULBERG ◽  
...  
Keyword(s):  
Risk Factors ◽  
Psychiatric Disorder ◽  
Family Caregivers ◽  
Heart Transplant ◽  
Transplant Recipients ◽  
Post Traumatic Stress ◽  
Entire Study ◽  
Post Transplant ◽  
Potential Risk Factors ◽  
The Impact

Background. Family members adopt key caregiving roles in the maintenance of transplant recipients' health. While the bulk of the caregiving literature suggests that rates of psychiatric disorder should be high in these caregivers, the potential benefits of transplantation may instead lead to less distress than in other caregiving situations. We examined prevalence and risk factors for depressive and anxiety-related disorders in caregivers throughout 3 years after their family member's heart transplant.Method. A total of 190 caregivers (97% of eligible respondents) were enrolled. They received psychiatric and psychosocial evaluations at 2, 7, 12 and 36 months post-transplant. Survival analysis determined cumulative rates of psychiatric disorders and the impact of potential risk factors.Results. Rates of depressive and anxiety-related disorders met or exceeded other caregiver populations' rates. By 3 years post-transplant, cumulative onset rates were: Major Depressive Disorder (MDD), 31·6%, Adjustment disorders, 35·4% (29·4% with anxious mood); Post-Traumatic Stress Disorder related to the transplant (PTSD-T), 22·5%, Generalized Anxiety Disorder, 7·3%, and any assessed disorder, 56·3%. PTSD-T occurred primarily during the first year post-transplant. Other disorders' rates increased over the entire study period. Risk for disorder was elevated by positive lifetime history of psychiatric disorder, greater post-transplant caregiving responsibilities, and a poorer relationship with the patient. Risk for MDD was further increased by caregiver unemployment, and risk for anxiety disorders was further increased by younger age, low sense of personal mastery, and high use of avoidance coping strategies.Conclusions. Transplantation is associated with costs and benefits for not only patients but family caregivers. Caregivers' risk for psychiatric illness should be considered when developing interventions to promote families' long-term adjustment to the transplant process.

One-year mirror-image study of the impact of olanzapine long-acting injection on healthcare resource utilization and costs in severe schizophrenia

2018 ◽  
Vol 270 ◽  
pp. 205-210 ◽  
Author(s):  
Mylène Fefeu ◽  
Pierre De Maricourt ◽  
Arnaud Cachia ◽  
Nicolas Hoertel ◽  
Marie-Noëlle Vacheron ◽  
...  
Keyword(s):  
Resource Utilization ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Mirror Image ◽  
Image Study ◽  
One Year ◽  
Long Acting ◽  
The Impact
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