Shraddha Shinde | University of Illinois at Chicago (original) (raw)
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Papers by Shraddha Shinde
INNOVATIONS in pharmacy
Background- Research on pharmacist provided care and services has rarely focused on medication co... more Background- Research on pharmacist provided care and services has rarely focused on medication cost and affordability. This study aims to bridge the gap by examining pharmacists' perspectives of medication costs and affordability. Objective- To explore pharmacists' perceptions about medication cost burden for patients, their communication with patients about i) ability to afford medications, ii) price, and iii) ways to reduce medication cost burden, their perceptions about ways to help improve affordability of medications and the barriers to communication. Method- A cross sectional exploratory study design was utilized. A convenience sample of pharmacists working in community pharmacies in Brooklyn was approached and asked to complete a survey. The survey questions examined the extent to which pharmacists: 1) perceived medication cost to be a burden, 2) initiated discussion about i) ability to afford medications, ii) price of medications, iii) ways to reduce cost burden. Pha...
INNOVATIONS in pharmacy
Most published reports of patient safety in clinical practice focus largely on the culture of saf... more Most published reports of patient safety in clinical practice focus largely on the culture of safety in complex health systems, separate from pre-approval and postmarketing research-related safety considerations for drugs, biologics, and other medical products. The science of safety requires a linked integrated perspective, i.e., an iterative process examining and relating safety concerns from drug or biologic discovery and development in preclinical stages, clinical trials and post-market use, research, surveillance, and potential regulatory changes. This commentary addresses the science of safety across the lifecycle of drug and biological products, regulatory considerations, barriers, and research needs. This paper provides a brief overview on how the functioning of healthcare systems affects the safety environment and describes how stakeholder involvement, research participation, and targeted education and training can help facilitate better safety measures and practices, provid...
Advances in Therapy
Introduction: After a patient with rheumatoid arthritis (RA) fails tumor necrosis factor inhibito... more Introduction: After a patient with rheumatoid arthritis (RA) fails tumor necrosis factor inhibitor (TNFi) treatment, clinical guidelines support either cycling to another TNFi or switching to a different mechanism of action (MOA), but payers often require TNFi cycling before they reimburse switching MOA. This study examined treatment persistence, cost, and cost per persistent patient among MOA switchers versus TNFi cyclers. Methods: This study of Commercial and Medicare Advantage claims data from the Optum Research Database included patients with RA and at least one claim for a TNFi (adalimumab, certolizumab pegol, etanercept, golimumab, or infliximab) between January 2012 and September 2015 who changed to another TNFi or a different MOA therapy (abatacept, tocilizumab, or tofacitinib) within 1 year. The index date was the date of the change in therapy. Treatment persistence was defined as no subsequent switch or 60-day gap in therapy for 1 year post-index. RA-related costs included plan-paid and patient-paid amounts for inpatient, outpatient, and pharmacy claims. Medication costs included index and post-index costs of TNFi and different MOA therapies. Results: There were 581 (38.3%) MOA switchers and 935 (61.7%) TNFi cyclers. The treatment persistence rate was significantly higher for MOA switchers versus TNFi cyclers (47.7% versus 40.2%, P = 0.004). Mean 1-year healthcare costs were significantly lower among MOA switchers versus TNFi cyclers for total RA-related costs
Journal of Pharmacovigilance, 2014
Objective: To examine the association between treprostinil sodium and pneumonia in patients with ... more Objective: To examine the association between treprostinil sodium and pneumonia in patients with pulmonary arterial hypertension, utilizing and analyzing the reports submitted to the Food and Drug Administration (FDA) Adverse Even Reporting System (AERS) and the published literature. Methods: A total of 5,332926 reports of adverse events between January 2006 and June 2012 were downloaded from the FDA AERS. These adverse events were associated with all other drugs inclusive of Treprostinil Sodium. A literature review was conducted on PubMed using the terms treprostinil and pneumonia. Authorized pharmacovigilance tools were used to determine the proportional reporting ratio, the reporting odds ratio, and the information component given by the Bayesian confidence propagation neural network. Results: Based on the numerous adverse event pairs, 144 adverse events were listed as treprostinil sodium associated with pneumonia. The majority of the cases were seen in females (74%) and those between the ages of 51 and 75 years (63%). The most common route of drug administration among the cases was inhalation (73%). Conclusion: This study helps indicate an association between the treatment with Treprostinil sodium and the development of pneumonia in pulmonary hypertensive patients. Additional research is needed to confirm with the medical relevance of the analysis.
Personalized Medicine, 2012
Aim: This study assessed pharmacist’s knowledge and confidence in pharmacogenomics (PGx)-related ... more Aim: This study assessed pharmacist’s knowledge and confidence in pharmacogenomics (PGx)-related concepts, and determined their needs with regard to education and training in PGx. Methods: A cross-sectional survey instrument was sent via postal mail to pharmacists (n = 319) who were randomly selected from the New York State database of licensed pharmacists. Descriptive and bivariate statistics were performed. Results: The response rate was 32% (n = 102). The majority (83%) of respondents had been exposed to basic concepts in genetics, while PGx was not an integral part of their education. Most respondents indicated being somewhat confident in their knowledge of PGx-related concepts. In addition, 64% of respondents reported being interested in attending 1–10 h of continuing education programs in PGx, and 42% of respondents indicated being interested in obtaining a certificate in PGx. Conclusion: Educational program development in the format of continuing education or certificate is n...
Background-Research on pharmacist provided care and services has rarely focused on medication cos... more Background-Research on pharmacist provided care and services has rarely focused on medication cost and affordability. This study aims to bridge the gap by examining pharmacists' perspectives of medication costs and affordability. Objective-To explore pharmacists' perceptions about medication cost burden for patients, their communication with patients about i) ability to afford medications, ii) price, and iii) ways to reduce medication cost burden, their perceptions about ways to help improve affordability of medications and the barriers to communication. Method-A cross sectional exploratory study design was utilized. A convenience sample of pharmacists working in community pharmacies in Brooklyn was approached and asked to complete a survey. The survey questions examined the extent to which pharmacists: 1) perceived medication cost to be a burden, 2) initiated discussion about i) ability to afford medications, ii) price of medications, iii) ways to reduce cost burden. Pharmacists were also asked to opine on how to improve affordability of medications and their perceived barriers for such communication with the patients. Questions were formulated to differentiate pharmacists' perceptions and behaviors in regards to dealing with patients with (PWI) and without insurance (PWOI). Data was analyzed using SPSS version 17.0. Result-A total of twenty-six pharmacists out of 54 approached participated in the study. Majority of the pharmacists reported the cost of medication to be extremely/very burdensome for PWOI (73%) than PWI (23%). In contrast, more pharmacists reported initiating a discussion very often/always about affordability with PWI (35%) than PWOI (20%). Discussions about price of medications were more common than discussions about affordability and ways to reduce medication burden. On an average, 33% of the pharmacists suggested generics as a way to improve affordability of the medications for PWI and PWOI. Conclusion-Patient-pharmacist communication on affordability and ways to reduce cost burden occurs very infrequently. Understanding the perspectives on patient-pharmacist communication on medication cost may help in developing effective strategies and may help reduce cost-related medication non-adherence.
INNOVATIONS in pharmacy
Background- Research on pharmacist provided care and services has rarely focused on medication co... more Background- Research on pharmacist provided care and services has rarely focused on medication cost and affordability. This study aims to bridge the gap by examining pharmacists' perspectives of medication costs and affordability. Objective- To explore pharmacists' perceptions about medication cost burden for patients, their communication with patients about i) ability to afford medications, ii) price, and iii) ways to reduce medication cost burden, their perceptions about ways to help improve affordability of medications and the barriers to communication. Method- A cross sectional exploratory study design was utilized. A convenience sample of pharmacists working in community pharmacies in Brooklyn was approached and asked to complete a survey. The survey questions examined the extent to which pharmacists: 1) perceived medication cost to be a burden, 2) initiated discussion about i) ability to afford medications, ii) price of medications, iii) ways to reduce cost burden. Pha...
INNOVATIONS in pharmacy
Most published reports of patient safety in clinical practice focus largely on the culture of saf... more Most published reports of patient safety in clinical practice focus largely on the culture of safety in complex health systems, separate from pre-approval and postmarketing research-related safety considerations for drugs, biologics, and other medical products. The science of safety requires a linked integrated perspective, i.e., an iterative process examining and relating safety concerns from drug or biologic discovery and development in preclinical stages, clinical trials and post-market use, research, surveillance, and potential regulatory changes. This commentary addresses the science of safety across the lifecycle of drug and biological products, regulatory considerations, barriers, and research needs. This paper provides a brief overview on how the functioning of healthcare systems affects the safety environment and describes how stakeholder involvement, research participation, and targeted education and training can help facilitate better safety measures and practices, provid...
Advances in Therapy
Introduction: After a patient with rheumatoid arthritis (RA) fails tumor necrosis factor inhibito... more Introduction: After a patient with rheumatoid arthritis (RA) fails tumor necrosis factor inhibitor (TNFi) treatment, clinical guidelines support either cycling to another TNFi or switching to a different mechanism of action (MOA), but payers often require TNFi cycling before they reimburse switching MOA. This study examined treatment persistence, cost, and cost per persistent patient among MOA switchers versus TNFi cyclers. Methods: This study of Commercial and Medicare Advantage claims data from the Optum Research Database included patients with RA and at least one claim for a TNFi (adalimumab, certolizumab pegol, etanercept, golimumab, or infliximab) between January 2012 and September 2015 who changed to another TNFi or a different MOA therapy (abatacept, tocilizumab, or tofacitinib) within 1 year. The index date was the date of the change in therapy. Treatment persistence was defined as no subsequent switch or 60-day gap in therapy for 1 year post-index. RA-related costs included plan-paid and patient-paid amounts for inpatient, outpatient, and pharmacy claims. Medication costs included index and post-index costs of TNFi and different MOA therapies. Results: There were 581 (38.3%) MOA switchers and 935 (61.7%) TNFi cyclers. The treatment persistence rate was significantly higher for MOA switchers versus TNFi cyclers (47.7% versus 40.2%, P = 0.004). Mean 1-year healthcare costs were significantly lower among MOA switchers versus TNFi cyclers for total RA-related costs
Journal of Pharmacovigilance, 2014
Objective: To examine the association between treprostinil sodium and pneumonia in patients with ... more Objective: To examine the association between treprostinil sodium and pneumonia in patients with pulmonary arterial hypertension, utilizing and analyzing the reports submitted to the Food and Drug Administration (FDA) Adverse Even Reporting System (AERS) and the published literature. Methods: A total of 5,332926 reports of adverse events between January 2006 and June 2012 were downloaded from the FDA AERS. These adverse events were associated with all other drugs inclusive of Treprostinil Sodium. A literature review was conducted on PubMed using the terms treprostinil and pneumonia. Authorized pharmacovigilance tools were used to determine the proportional reporting ratio, the reporting odds ratio, and the information component given by the Bayesian confidence propagation neural network. Results: Based on the numerous adverse event pairs, 144 adverse events were listed as treprostinil sodium associated with pneumonia. The majority of the cases were seen in females (74%) and those between the ages of 51 and 75 years (63%). The most common route of drug administration among the cases was inhalation (73%). Conclusion: This study helps indicate an association between the treatment with Treprostinil sodium and the development of pneumonia in pulmonary hypertensive patients. Additional research is needed to confirm with the medical relevance of the analysis.
Personalized Medicine, 2012
Aim: This study assessed pharmacist’s knowledge and confidence in pharmacogenomics (PGx)-related ... more Aim: This study assessed pharmacist’s knowledge and confidence in pharmacogenomics (PGx)-related concepts, and determined their needs with regard to education and training in PGx. Methods: A cross-sectional survey instrument was sent via postal mail to pharmacists (n = 319) who were randomly selected from the New York State database of licensed pharmacists. Descriptive and bivariate statistics were performed. Results: The response rate was 32% (n = 102). The majority (83%) of respondents had been exposed to basic concepts in genetics, while PGx was not an integral part of their education. Most respondents indicated being somewhat confident in their knowledge of PGx-related concepts. In addition, 64% of respondents reported being interested in attending 1–10 h of continuing education programs in PGx, and 42% of respondents indicated being interested in obtaining a certificate in PGx. Conclusion: Educational program development in the format of continuing education or certificate is n...
Background-Research on pharmacist provided care and services has rarely focused on medication cos... more Background-Research on pharmacist provided care and services has rarely focused on medication cost and affordability. This study aims to bridge the gap by examining pharmacists' perspectives of medication costs and affordability. Objective-To explore pharmacists' perceptions about medication cost burden for patients, their communication with patients about i) ability to afford medications, ii) price, and iii) ways to reduce medication cost burden, their perceptions about ways to help improve affordability of medications and the barriers to communication. Method-A cross sectional exploratory study design was utilized. A convenience sample of pharmacists working in community pharmacies in Brooklyn was approached and asked to complete a survey. The survey questions examined the extent to which pharmacists: 1) perceived medication cost to be a burden, 2) initiated discussion about i) ability to afford medications, ii) price of medications, iii) ways to reduce cost burden. Pharmacists were also asked to opine on how to improve affordability of medications and their perceived barriers for such communication with the patients. Questions were formulated to differentiate pharmacists' perceptions and behaviors in regards to dealing with patients with (PWI) and without insurance (PWOI). Data was analyzed using SPSS version 17.0. Result-A total of twenty-six pharmacists out of 54 approached participated in the study. Majority of the pharmacists reported the cost of medication to be extremely/very burdensome for PWOI (73%) than PWI (23%). In contrast, more pharmacists reported initiating a discussion very often/always about affordability with PWI (35%) than PWOI (20%). Discussions about price of medications were more common than discussions about affordability and ways to reduce medication burden. On an average, 33% of the pharmacists suggested generics as a way to improve affordability of the medications for PWI and PWOI. Conclusion-Patient-pharmacist communication on affordability and ways to reduce cost burden occurs very infrequently. Understanding the perspectives on patient-pharmacist communication on medication cost may help in developing effective strategies and may help reduce cost-related medication non-adherence.