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OBJECTIVE To assess risks of mortality associated with use of individual antipsychotic drugs in elderly residents in nursing homes. DESIGN Population based cohort study with linked data from Medicaid, Medicare, the Minimum Data Set, the National Death Index, and a national assessment of nursing home quality. SETTING Nursing homes in the United States.(More)
BACKGROUND Although animal studies have raised the possibility that prolactin-elevating dopamine antagonists used to treat psychotic disorders may initiate and promote breast cancers, epidemiologic studies in humans have been limited and inconsistent. METHODS A retrospective cohort study was conducted of 52 819 women exposed and 55 289 not exposed to(More)
BACKGROUND Patients with chronic disease often take many medications multiple times per day. Such regimen complexity is associated with medication nonadherence. Other factors, including the number of pharmacy visits patients make to pick up their prescriptions, may also undermine adherence. Our objective was to estimate the extent of prescribing and filling(More)
BACKGROUND Episodes of sudden uncontrollable somnolence have been reported in patients with Parkinson disease (PD) receiving dopamine agonists, including pramipexole and ropinirole, but controversy persists concerning their nature, severity, and frequency. OBJECTIVES To quantify the risk of sudden uncontrollable somnolence in patients taking specific PD(More)
Confounding can be a major source of bias in nonexperimental research. The authors recently introduced propensity score calibration (PSC), which combines propensity scores and regression calibration to address confounding by variables unobserved in the main study by using variables observed in a validation study. Here, the authors assess the performance of(More)
Recent reports have raised the concern that clozapine increases the risk for diabetes mellitus. Accurate pharmacoepidemiologic data on whether such a hazard exists and its magnitude are needed to enable clinicians and patients to make proper treatment decisions about clozapine. The authors performed a case-control study involving 7,227 cases of newly(More)
BACKGROUND Medication nonadherence is a major public health problem, especially for patients with coronary artery disease. The cost of prescription drugs is a central reason for nonadherence, even for patients with drug insurance. Removing patient out-of-pocket drug costs may increase adherence, improve clinical outcomes, and even reduce overall health(More)
OBJECTIVE The risk of depression in women is greatest at childbearing age. We sought to examine and explain national trends in antidepressant use in pregnant women. METHODS This was a cohort study including pregnant women aged 12-55 who were enrolled in Medicaid during 2000-2007. We examined the proportion of women taking antidepressants during pregnancy(More)
OBJECTIVE While benzodiazepine treatment is known to increase the risk of hip fracture in older populations, controversy persists over which characteristics of benzodiazepine use (e.g., elimination half-life, dosage, duration of use) are most associated with such risks. METHOD The authors reviewed the health care utilization data of 1,222 hip fracture(More)
Seven percent of all health expenditures in the United States in 1987 was allocated for medications. Accurate prescribing decisions thus have crucial implications for both economic and clinical aspects of health care. A review of 44 empirical studies indicates that different strategies to improve the prescription practices of primary care physicians have(More)