Browsing by Subject "Biological Products"
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Item Open Access Factors Related to Biologic Adherence and Outcomes Among Moderate-to-Severe Asthma Patients.(The journal of allergy and clinical immunology. In practice, 2022-09) Osazuwa-Peters, Oyomoare L; Greiner, Melissa A; Oberle, Amber; Oakes, Megan; Thomas, Sheila M; Bosworth, HaydenBackground
Adherence barriers to asthma biologics may not be uniform across administration settings for patients with moderate-to-severe asthma.Objective
To examine differences in asthma biologic adherence and associated factors, as well as association with a 1-year all-cause emergency department (ED) visit, across administration settings.Methods
A retrospective study of biologic naïve moderate-to-severe asthma patients with initial biologic therapy between January 1, 2016, and April 30, 2020, in the Optum Clinformatics Data Mart was performed. Three administration settings were identified: Clinic-only (outpatient office/infusion center), Home (self-administration), and Hybrid setting (mixture of clinic and self-administration). Asthma biologic adherence was the proportion of observed over expected biologic dose administrations received within 6 months from initial therapy. Factors associated with adherence were identified by administration setting, using Poisson regression analyses. A relationship between a 1-year all-cause ED visit and adherence was assessed for each administration setting using Cox regression analyses.Results
The study cohort was 3932 patients. Biologics adherence was 0.75 [0.5, 1] in Clinic setting, the most common administration setting, and 0.83 [0.5, 1] in both Home and Hybrid settings. Specialist access was consistently associated with better biologic adherence, whereas Black race, Hispanic ethnicity, lower education, Medicare only insurance, and higher patient out-of-pocket cost were associated with worse biologic adherence in some settings. In the Hybrid setting, hazard for a 1-year all-cause ED visit decreased with biologic adherence.Conclusions
Asthma biologic adherence varied by administration setting. Efforts to improve asthma biologic adherence should consider promoting self-administration when beneficial, improving prior specialist access, and targeting patients with higher risk of suboptimal adherence particularly Black and Hispanic patients.Item Open Access Introduction. Biologics in spine surgery.(Neurosurgical focus, 2021-06) Levi, Allan D; Shaffrey, Christopher I; Haid, Regis W; Boden, Scott D; Clarke, Michelle J; Mazur, Marcus D