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Your search keyword '"Kruti Joshi"' showing total 4 results
Start Over Author "Kruti Joshi" Journal journal of comparative effectiveness research
4 results on '"Kruti Joshi"'

1. Real-world assessment of treatment inertia in the management of patients treated for major depressive disorder in the USA

Author

John J Sheehan, Chris LaVallee, Keshia Maughn, Santosh Balakrishnan, Jacqueline A Pesa, Kruti Joshi, and Craig Nelson

Subjects
depressive disorder, major depressive disorder, treatment inertia, Public aspects of medicine, RA1-1270
Abstract

Aim: Major depressive disorder (MDD) is a debilitating illness in which depressive symptoms may persist after treatment. Treatment inertia is the continued use of the same pharmacotherapy regimen when treatment goals are not met. This study assessed the frequency of treatment inertia among adult patients with MDD treated in a real-world setting. Patients & methods: This was a retrospective, observational study of patients with MDD identified in the Decision Resources Group Real World Evidence US Data Repository from January 2014 to June 2018. Patients (≥18 years) had an elevated Patient Health Questionnaire-9 (PHQ-9) score (≥5) following 8 weeks of stable baseline antidepressant use with/without mental-health outpatient therapy. Treatment inertia, modification and discontinuation were evaluated over a 16-week follow-up period (timeline based on the APA Practice Guidelines). The primary outcome was the proportion of MDD patients experiencing treatment inertia. Results: 2850 patients (median age, 55 years; 74% female) met the study criteria. Of these patients, 834 (29%) had study-defined treatment inertia, 1534 (54%) received treatment modification and 482 (17%) discontinued treatment. Use of mirtazapine (Odd ratio [OR]: 0.63; 95% confidence interval [CI]: 0.50–0.79), selective serotonin reuptake inhibitors (OR: 0.64; 95% CI: 0.54–0.75) or bupropion (OR: 0.71; 95% CI: 0.60–0.84) in the baseline period was associated with an increased likelihood of treatment modification versus not receiving treatment with these medications. Frequency of treatment inertia may differ among those who do not have a documented PHQ-9 score. Conclusion: Effective symptom management is critical for optimal outcomes in MDD. Results demonstrate that treatment inertia is common in MDD despite guidelines recommending treatment modification in patients not reaching remission.

Published
2023
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2. US budget impact analysis of esketamine nasal spray in major depressive disorder with acute suicidal ideation/behavior

Author

Jennifer Voelker, John J Sheehan, Hoa H Le, Hector Toro-Diaz, Shujun Li, and Kruti Joshi

Subjects
Adult, Depressive Disorder, Major, Health Policy, Humans, Ketamine, Health Care Costs, Nasal Sprays, health care economics and organizations, Administration, Intranasal, Suicidal Ideation
Abstract

Background: Esketamine nasal spray plus an oral antidepressant is approved in adults with major depressive disorder with acute suicidal ideation or behavior (MDSI). Methods: A budget impact analysis from a US payer perspective was performed with a hypothetical 1-million-member plan, using pharmacy and medical costs associated with adding esketamine plus an oral antidepressant to usual care. Results: Estimated annual total healthcare costs of managing patients with MDSI increased from $32,988,247 without esketamine to $34,161,188 in Year 3 with esketamine (primarily due to medical costs). The per-member-per-month incremental costs were $0.02, $0.06 and $0.10 in Years 1, 2 and 3, respectively. Conclusion: Incorporation of esketamine results in a modest estimated impact on the annual budget over a 3-year time horizon.

Published
2022

3. Adherence and economic impact of paliperidone palmitate versus oral atypical antipsychotics in a Medicare population

Author

Erik Muser, Brandon T. Suehs, Kruti Joshi, Phil Schwab, Manasi Datar, and Yihua Xu

Subjects
Adult, Male, medicine.medical_specialty, Administration, Oral, Pharmacy, Medicare Advantage, Medicare, Medication Adherence, Odds, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Paliperidone Palmitate, medicine, Humans, Longitudinal Studies, 030212 general & internal medicine, health care economics and organizations, Aged, Retrospective Studies, Aged, 80 and over, Health economics, business.industry, Health Policy, Odds ratio, Middle Aged, Patient Acceptance of Health Care, medicine.disease, United States, Hospitalization, Schizophrenia, Medicare population, Female, business, Models, Econometric, 030217 neurology & neurosurgery, Antipsychotic Agents
Abstract

Aim: To compare adherence, healthcare utilization and costs among real world, Medicare-eligible patients with schizophrenia using long-acting injectable paliperidone palmitate (PP) versus oral atypical antipsychotics. Patients & methods: Historical cohort study used Medicare Advantage claims data. Inverse probability of treatment weighting was applied to adjust for baseline differences. 12-month adherence, healthcare utilization and costs were compared. Results: Patients using PP were more adherent (proportion of days covered ≥0.8; 48.1 vs 32.6%; p Conclusion: Compared with patients using oral atypical antipsychotics, PP had lower hospitalizations and medical costs with greater medication adherence accompanied by higher pharmacy costs.

Published
2018
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4. Real-world adherence and economic outcomes associated with paliperidone palmitate versus oral atypical antipsychotics in schizophrenia patients with substance-related disorders using Medicaid benefits

Author

Patrick Lefebvre, Marie-Hélène Lafeuille, Kruti Joshi, Sean Tiggelaar, Yong Yue, Neeta Tandon, Rhiannon Kamstra, and Edward Kim

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Substance-Related Disorders, medicine.drug_class, medicine.medical_treatment, Administration, Oral, Atypical antipsychotic, Pharmacy, Drug Administration Schedule, Medication Adherence, Persistence (computer science), Young Adult, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Paliperidone Palmitate, Health care, medicine, Humans, Antipsychotic, Retrospective Studies, Medicaid, business.industry, Health Policy, Health Care Costs, Middle Aged, medicine.disease, United States, 030227 psychiatry, Hospitalization, Treatment Outcome, Diagnosis, Dual (Psychiatry), Schizophrenia, Costs and Cost Analysis, Health Resources, Female, business, Facilities and Services Utilization, 030217 neurology & neurosurgery, Antipsychotic Agents
Abstract

Aim: Compare medication utilization, costs and healthcare resource use in schizophrenia patients with substance-related disorders initiated on once-monthly paliperidone palmitate (PP1M) or an oral atypical antipsychotic (OAA). Materials & methods: Data from six Medicaid states (07/2009–03/2015) were used to compare outcomes between PP1M and OAA patients. Results: PP1M patients had higher 12-month antipsychotic adherence and persistence than OAA patients. PP1M patients had lower medical (mean monthly cost difference [MMCD] = US$-191, p = 0.020), higher pharmacy (MMCD = US$250, p Conclusion: PP1M was associated with higher antipsychotic adherence and persistence, and similar total costs versus OAA.

Published
2018
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