| Title |
Patterns of health care utilization related to initiation of amitriptyline, duloxetine, gabapentin, or pregabalin in fibromyalgia
|
|---|---|
| Published in |
Arthritis Research & Therapy, January 2015
|
| DOI | 10.1186/s13075-015-0530-8 |
| Pubmed ID | |
| Authors |
Seoyoung C Kim, Joan E Landon, Yvonne C Lee |
| Abstract |
IntroductionSeveral pharmacologic treatments are available for fibromyalgia, but little is known about comparative effectiveness of these treatments on health care utilization.MethodsUsing US commercial insurance claims data (2007 to 2009), we conducted a cohort study to examine comparative effectiveness of amitriptyline, duloxetine, gabapentin, and pregabalin on health care utilization in patients with fibromyalgia. We measured patients¿ medication adherence using the proportion of days covered (PDC) and estimated multivariable rate ratios (RR) for outpatient visits, prescriptions, hospitalization, and emergency department (ED) visits in propensity score (PS)-matched cohorts.Results8,269 amitriptyline, 9,941 duloxetine and 18,613 gabapentin initiators were compared with their PS-matched pregabalin initiators. During the baseline 180-day period, patients had on average 7 to 9 physician visits including 6 to 8 specialist visits and received eight prescription drugs. The mean PDC up to 180 days varied from 38.6 to 67.7%. The number of outpatient visits, prescriptions and hospitalization decreased slightly after initiating one of the study drugs, but the number of ED visits increased after treatment initiation. Duloxetine was associated with decreased outpatient visits (RR 0.94, 95% confidence interval (CI) 0.88 to 1.00), prescriptions (RR 0.94, 95% CI 0.90 to 0.98), hospitalization (RR 0.75, 95% CI 0.68 to 0.83), and ED visits (RR 0.85, 95% CI 0.79 to 0.91) versus pregabalin. Little differences in health care utilization rates were noted among amitriptyline and gabapentin initiators, compared to pregabalin.ConclusionsFibromyalgia patients had high health care utilization before and after initiation of amitriptyline, duloxetine, gabapentin, or pregabalin. Medication adherence was suboptimal. Overall, fibromyalgia treatment had little impact on reducing health care utilization, but duloxetine initiators had less health care utilization than pregabalin. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Brazil | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 55 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 1 | 2% |
| Canada | 1 | 2% |
| Unknown | 53 | 96% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 14 | 25% |
| Other | 6 | 11% |
| Student > Postgraduate | 6 | 11% |
| Researcher | 6 | 11% |
| Student > Doctoral Student | 5 | 9% |
| Other | 5 | 9% |
| Unknown | 13 | 24% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 18 | 33% |
| Nursing and Health Professions | 6 | 11% |
| Pharmacology, Toxicology and Pharmaceutical Science | 3 | 5% |
| Social Sciences | 3 | 5% |
| Psychology | 3 | 5% |
| Other | 9 | 16% |
| Unknown | 13 | 24% |
Attention Score in Context
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#17,285,036
of 25,371,288 outputs
Outputs from Arthritis Research & Therapy
#2,536
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#222,128
of 361,110 outputs
Outputs of similar age from Arthritis Research & Therapy
#40
of 56 outputs
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