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1414. Real-World Study of Healthcare Resource Use and Costs Associated with Inappropriate and Suboptimal Antibiotic Use Among Females with Uncomplicated Urinary Tract Infection in the United States

BACKGROUND: Urinary tract infections (UTIs) are the most common outpatient infection requiring medical care in the US; but, despite Infectious Diseases Society of America 2011 guidelines for treating uncomplicated UTI (uUTI), variation in prescribing practices still exists. Few studies have used rea...

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Autores principales: Preib, Madison T, Mitrani-Gold, Fanny S, Sun, Xiaoxi, Adams, Christopher, Joshi, Ashish V
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8644320/
http://dx.doi.org/10.1093/ofid/ofab466.1606
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author Preib, Madison T
Mitrani-Gold, Fanny S
Sun, Xiaoxi
Adams, Christopher
Joshi, Ashish V
author_facet Preib, Madison T
Mitrani-Gold, Fanny S
Sun, Xiaoxi
Adams, Christopher
Joshi, Ashish V
author_sort Preib, Madison T
collection PubMed
description BACKGROUND: Urinary tract infections (UTIs) are the most common outpatient infection requiring medical care in the US; but, despite Infectious Diseases Society of America 2011 guidelines for treating uncomplicated UTI (uUTI), variation in prescribing practices still exists. Few studies have used real-world data (RWD) to evaluate uUTI-associated healthcare resource use (HRU) and costs. We examined HRU and direct costs associated with appropriate and optimal (AP&OP) and inappropriate or suboptimal (IA/SO) antibiotic (AB) prescribing in females with uUTI using US RWD. METHODS: This retrospective cohort study used RWD from IBM MarketScan (commercial/Medicare claims) to examine uUTI-related HRU and costs (inpatient, emergency room, outpatient, pharmacy) per index uUTI episode and during 1-year follow-up among females (age ≥ 12 years) diagnosed with uUTI from July 1, 2013–December 31, 2017 (index date). Patients had an oral AB prescription ± 5 days of the index date, and continuous health plan enrollment ≥ 6 months pre/1 year post-index date; those with complicated UTI were excluded. Patients were stratified by AB prescription as follows: AP&OP = guideline-compliant and correct duration; IA/SO = guideline non-compliant/incorrect duration or re-prescription/switch within 28 days. RESULTS: The study included 557,669 patients. In the commercial population (n=517,664, mean age 37.7 years), fewer patients were prescribed AP&OP (11.8%) than IA/SO (88.2%) ABs, a trend also seen in the Medicare population (n=40,005, mean age 74.5 years). In both populations, adjusted average numbers of uUTI-related ambulatory visits and pharmacy claims were lower for the AP&OP cohort than the IA/SO cohort during index episode and 1-year followup (p < 0.0001, Table 1). In the commercial population, total adjusted uUTI-related costs were &194 (AP&OP) versus &274 (IA/SO; p < 0.0001); in the Medicare population, total adjusted uUTI-related costs were &253 (AP&OP) versus &355 (IA/SO; p < 0.0001) (Table 2). Table 1. uUTI-related HRU for commercial and Medicare populations calculated using the GLM model [Image: see text] Table 2. uUTI-related costs for commercial and Medicare populations calculated using the GLM model [Image: see text] CONCLUSION: Overall uUTI-related HRU and costs in the US were low during index episodes and follow-up. However, females with uUTI prescribed IA/SO ABs were more likely to incur higher HRU and costs than those prescribed AP&OP ABs, suggesting an unmet need for training to optimize uUTI prescribing per US guidelines. DISCLOSURES: Madison T. Preib, MPH, STATinMED Research (Employee, Former employee of STATinMED Research, which received funding from GlaxoSmithKline plc. to conduct this study) Fanny S. Mitrani-Gold, MPH, GlaxoSmithKline plc. (Employee, Shareholder) Xiaoxi Sun, MA, STATinMED Research (Employee, Employee of STATinMED Research, which received funding from GlaxoSmithKline plc. to conduct this study) Christopher Adams, MPH, STATinMED Research (Employee, Employee of STATinMED Research, which received funding from GlaxoSmithKline plc. to conduct this study) Ashish V. Joshi, PhD, GlaxoSmithKline plc. (Employee, Shareholder)
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spelling pubmed-86443202021-12-06 1414. Real-World Study of Healthcare Resource Use and Costs Associated with Inappropriate and Suboptimal Antibiotic Use Among Females with Uncomplicated Urinary Tract Infection in the United States Preib, Madison T Mitrani-Gold, Fanny S Sun, Xiaoxi Adams, Christopher Joshi, Ashish V Open Forum Infect Dis Poster Abstracts BACKGROUND: Urinary tract infections (UTIs) are the most common outpatient infection requiring medical care in the US; but, despite Infectious Diseases Society of America 2011 guidelines for treating uncomplicated UTI (uUTI), variation in prescribing practices still exists. Few studies have used real-world data (RWD) to evaluate uUTI-associated healthcare resource use (HRU) and costs. We examined HRU and direct costs associated with appropriate and optimal (AP&OP) and inappropriate or suboptimal (IA/SO) antibiotic (AB) prescribing in females with uUTI using US RWD. METHODS: This retrospective cohort study used RWD from IBM MarketScan (commercial/Medicare claims) to examine uUTI-related HRU and costs (inpatient, emergency room, outpatient, pharmacy) per index uUTI episode and during 1-year follow-up among females (age ≥ 12 years) diagnosed with uUTI from July 1, 2013–December 31, 2017 (index date). Patients had an oral AB prescription ± 5 days of the index date, and continuous health plan enrollment ≥ 6 months pre/1 year post-index date; those with complicated UTI were excluded. Patients were stratified by AB prescription as follows: AP&OP = guideline-compliant and correct duration; IA/SO = guideline non-compliant/incorrect duration or re-prescription/switch within 28 days. RESULTS: The study included 557,669 patients. In the commercial population (n=517,664, mean age 37.7 years), fewer patients were prescribed AP&OP (11.8%) than IA/SO (88.2%) ABs, a trend also seen in the Medicare population (n=40,005, mean age 74.5 years). In both populations, adjusted average numbers of uUTI-related ambulatory visits and pharmacy claims were lower for the AP&OP cohort than the IA/SO cohort during index episode and 1-year followup (p < 0.0001, Table 1). In the commercial population, total adjusted uUTI-related costs were &194 (AP&OP) versus &274 (IA/SO; p < 0.0001); in the Medicare population, total adjusted uUTI-related costs were &253 (AP&OP) versus &355 (IA/SO; p < 0.0001) (Table 2). Table 1. uUTI-related HRU for commercial and Medicare populations calculated using the GLM model [Image: see text] Table 2. uUTI-related costs for commercial and Medicare populations calculated using the GLM model [Image: see text] CONCLUSION: Overall uUTI-related HRU and costs in the US were low during index episodes and follow-up. However, females with uUTI prescribed IA/SO ABs were more likely to incur higher HRU and costs than those prescribed AP&OP ABs, suggesting an unmet need for training to optimize uUTI prescribing per US guidelines. DISCLOSURES: Madison T. Preib, MPH, STATinMED Research (Employee, Former employee of STATinMED Research, which received funding from GlaxoSmithKline plc. to conduct this study) Fanny S. Mitrani-Gold, MPH, GlaxoSmithKline plc. (Employee, Shareholder) Xiaoxi Sun, MA, STATinMED Research (Employee, Employee of STATinMED Research, which received funding from GlaxoSmithKline plc. to conduct this study) Christopher Adams, MPH, STATinMED Research (Employee, Employee of STATinMED Research, which received funding from GlaxoSmithKline plc. to conduct this study) Ashish V. Joshi, PhD, GlaxoSmithKline plc. (Employee, Shareholder) Oxford University Press 2021-12-04 /pmc/articles/PMC8644320/ http://dx.doi.org/10.1093/ofid/ofab466.1606 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Poster Abstracts
Preib, Madison T
Mitrani-Gold, Fanny S
Sun, Xiaoxi
Adams, Christopher
Joshi, Ashish V
1414. Real-World Study of Healthcare Resource Use and Costs Associated with Inappropriate and Suboptimal Antibiotic Use Among Females with Uncomplicated Urinary Tract Infection in the United States
title 1414. Real-World Study of Healthcare Resource Use and Costs Associated with Inappropriate and Suboptimal Antibiotic Use Among Females with Uncomplicated Urinary Tract Infection in the United States
title_full 1414. Real-World Study of Healthcare Resource Use and Costs Associated with Inappropriate and Suboptimal Antibiotic Use Among Females with Uncomplicated Urinary Tract Infection in the United States
title_fullStr 1414. Real-World Study of Healthcare Resource Use and Costs Associated with Inappropriate and Suboptimal Antibiotic Use Among Females with Uncomplicated Urinary Tract Infection in the United States
title_full_unstemmed 1414. Real-World Study of Healthcare Resource Use and Costs Associated with Inappropriate and Suboptimal Antibiotic Use Among Females with Uncomplicated Urinary Tract Infection in the United States
title_short 1414. Real-World Study of Healthcare Resource Use and Costs Associated with Inappropriate and Suboptimal Antibiotic Use Among Females with Uncomplicated Urinary Tract Infection in the United States
title_sort 1414. real-world study of healthcare resource use and costs associated with inappropriate and suboptimal antibiotic use among females with uncomplicated urinary tract infection in the united states
topic Poster Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8644320/
http://dx.doi.org/10.1093/ofid/ofab466.1606
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