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Record Database (record + database)
Selected AbstractsThe Stability of Child Physical Placements Following Divorce: Descriptive Evidence From WisconsinJOURNAL OF MARRIAGE AND FAMILY, Issue 2 2008Lawrence M. Berger This study uses administrative data from the Wisconsin Court Record Database, linked with survey data collected from mothers (n= 789) and fathers (n= 690), to describe the living arrangements of children with sole mother and shared child physical placement following parental divorce. Contrary to prior research, results provide little evidence that children with shared placement progressively spend less time in their father's care. We find that, over (approximately) 3 years following a divorce, their living arrangements are as stable as those of children with sole mother placement or more so. To the extent that shared physical placement is associated with increased father involvement and positive developmental outcomes, recent increases in shared physical custody following divorce may benefit children. [source] Asthma medication , persistence with adrenergics, steroids and combination products over a 5-year periodJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 5 2009D. Haupt RPh Summary Background:, Many patients with asthma underuse steroids for inhalation. This has been identified as a main cause of therapy failure and of excess health care utilization. Objective:, To elucidate the medication persistence of patients using asthma drugs, how patients combine the drugs over time and whether medication persistence was influenced by patients switching to combination products. Methods:, Individual patients' drug acquisition data were obtained from a pharmacy record database for the period 2000,2004. A patient was considered to have satisfactory medication possession ratio (MPR) if the medication supplies covered ,80% of the prescribed treatment. Drug use profiles were constructed as graphs for each patient, showing the date of each refill and the time period covered by the dispensed drugs. From the graphs the combination of drugs, the continuity of the therapy over time and the MPR for each patient could be determined. Results:, Of 1812 patients with asthma drugs in the database, 815 fulfilled the inclusion criteria. The percentage of patients with satisfactory MPR was low (11,27%), but significantly higher among patients using combination products than among those using steroids. For patients who switched from adrenergics plus steroids in two inhalers to combination products in one inhaler, the number of patients with satisfactory MPR was significantly increased. Conclusion:, Satisfactory MPR was low for all types of asthma drugs. More patients had satisfactory MPR with combination products in one inhaler than with adrenergics and steroids in two separate inhalers. Asthma drug-delivery is important and combination products of the two ingredients could therefore improve asthma therapy. [source] Intussusception: Trends in clinical presentation and managementJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 5 2006FRANCES A JUSTICE Abstract Background:, The association of a rotavirus vaccine and intussusception has renewed interest in understanding the incidence, clinical presentation and outcome of intussusception. Methods:, A retrospective chart review of all patients diagnosed with intussusception at Royal Children's Hospital, Melbourne over a 6.5-year period (1 January 1995,30 June 2001) was conducted using patients identified by a medical record database (ICD-9-CM code 560.0 1993,1997; ICD-10-CM code 56.1 1998,2001). Patient profile, clinical presentation, diagnosis methods, treatment and outcome were analyzed and compared to data previously reported on children with intussusception at the same hospital during 1962,1968. Results:, The hospitalization rate for primary idiopathic intussusception increased marginally from 0.19 to 0.27 per 1000 live births during the period 1962,1968 to 1995,2001. Most patients (80%) were <12 months of age (median age 7 months, range 2,72 months). The combination of abdominal pain, lethargy and vomiting was reported in 78% of infants. Air enema confirmed the diagnosis of intussusception in 186 of 191 cases (97%) and air reduction was successful in most cases (82%). Factors associated with increased risk of intestinal resection included abdominal distension (32%), bowel obstruction on abdominal X-ray (27%) and hypovolemic shock (40%). No mortality was observed in the present study. Conclusions:, Over the past 40 years at Royal Children's Hospital, Melbourne the hospitalization rate due to primary idiopathic intussusception has marginally increased from 0.19 to 0.27 per 1000 live births. Diagnosis and treatment using air enema has been highly successful, resulting in a reduction in patients requiring surgery and reduced hospital stays. [source] Replication of the Scandinavian Simvastatin Survival Study using a primary care medical record database prompted exploration of a new method to address unmeasured confoundingPHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 7 2008Mark G. Weiner M.D. Abstract Purpose To examine whether identifiable study characteristics and/or analytic methods used determine observational study validity, as assessed by replicating randomized controlled trials using observational data. Methods A cohort from the United Kingdom General Practice Research Database (GPRD) was used to replicate the Scandinavian Simvastatin Survival Study RCT, which investigated statin treatment of hypercholesterolemic subjects with coronary heart disease. All aspects of the RCT except randomization were replicated to the extent possible in the GPRD study, which included 2,871 Unexposed and 1,280 statin-treated Exposed subjects. Results Overall mortality [adjusted hazard ratio 0.71 (0.53,0.96)] and myocardial infarction [adjusted HR 0.79 (0.61,1.02)] decreased in the GPRD study similar to the RCT. Coronary revascularization increased two-fold in the GPRD study, whereas it decreased significantly in the RCT [0.63 (0.54,0.74)]. This latter disparity prompted use of a new methodology to adjust for unmeasured confounding, which yielded an adjusted HR [1.0 (0.75,1.33)] more comparable to the RCT. Conclusions This study provides additional evidence that a replicated GPRD observational study can yield results reasonably similar to a RCT. More important, it provides preliminary evidence suggesting that a new analytic methodology may adjust for unmeasured confounding, the major limitation to research using observational data. Copyright © 2008 John Wiley & Sons, Ltd. [source] Refill adherence for patients with asthma and COPD: comparison of a pharmacy record database with manually collected repeat prescriptions,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 4 2007Kristin Krigsman MSc Abstract Purpose To compare refill adherence data based on two different methods of data capturing, that is, manually collected repeat prescriptions and a pharmacy record database. Methods The study comprised a comparison of adherence data from manually collected repeat prescriptions of asthma and chronic obstructive pulmonary disease (COPD) drugs with fixed dosages dispensed in 2002 and the corresponding data from a pharmacy record database. Data were collected in the county of Jämtland in Sweden. Refill adherence was calculated for the different collection methods. Results Data from 285 manually collected repeat prescriptions for asthma/COPD drugs for 2002 showed that 35% of the prescribings had been satisfactory refilled, while 42% showed an undersupply and 23% an oversupply. The pharmacy record database had 490 prescribings for asthma/COPD drugs registered in 2002, 28% of these had a satisfactory refill adherence, while 43% showed an undersupply, and 29% an oversupply. Based on the database it could be shown that 11% of the individuals had used more than one repeat prescription of the same medicine during 2002. Based on the pharmacy record database for 1999,2002, it was shown that 29% of the prescribings had been satisfactory refilled whereas undersupply increased (53%) and oversupply decreased (18%) as compared to the 1-year data. Conclusions Refill adherence determined from manually collected repeat prescriptions and from a pharmacy record database did not differ for a 1-year period. Four-year data might give a better overview of patients' refill adherence than 1-year data. Copyright © 2006 John Wiley & Sons, Ltd. [source] | ||||||||||