Understanding Temporal Patterns in Hypertensive Drug Therapy
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1 Understanding Temporal Patterns in Hypertensive Drug Therapy 1 Margret Bjarnadottir, 2 Sana Malik, 2 Catherine Plaisant, 3 Eberechukwu Onukwugha 1 Smith School of Business, University of Maryland, College Park 2 Department of Computer Science, University of Maryland, College Park 3 School of Pharmacy, University of Maryland, Baltimore May 28, 2015 HCIL 32 nd Annual Symposium
2 Worsened conditions Adverse outcomes Increased risk of death 2
3 Hospitalization costs due to medication non-adherence are estimated as high as $13 billion annually. Sullivan et al., Noncompliance with medication regimens and subsequent hospitalizations: a literature analysis and cost of hospitalization estimate, Journal of Research in Pharmaceutical Economics, Vol. 2, No. 2. (1990), pp
4 Medication Possession Ratio (MPR) days supplied length of observation period 4
5 Medication Possession Ratio (MPR) days supplied length of observation period Study start Study end time 4
6 Medication Possession Ratio (MPR) days supplied length of observation period = 100% Study start Study end time 4
7 Medication Possession Ratio (MPR) days supplied length of observation period = 83% Study start Study end time 4
8 Medication Possession Ratio (MPR) days supplied = 75% length of observation period Study start Study end time 5
9 Hypertensive Drug Therapy ACE ARB CCB Beta Diur Angiotension-Converting Enzyme-Inhibitors Angiotension II Receptor Blockers Calcium Channel Blockers Beta Blockers Diuretics 6
10 Hypertensive Drug Therapy time
11 Hypertensive Drug Therapy time
12 Hypertensive Drug Therapy time
13 Hypertensive Drug Therapy time
14 Hypertensive Drug Therapy time
15 Hypertensive Drug Therapy time
16 Hypertensive Drug Therapy time
17 Hypertensive Drug Therapy time
18 Hypertensive Drug Therapy time
19 Hypertensive Drug Therapy time
20 Hypertensive Drug Therapy time
21 Hypertensive Drug Therapy time
22 Hypertensive Drug Therapy time
23 Hypertensive Drug Therapy time
24 Hypertensive Drug Therapy time
25 Hypertensive Drug Therapy time
26 Hypertensive Drug Therapy time
27 Hypertensive Drug Therapy time
28 Hypertensive Drug Therapy time
29 Hypertensive Drug Therapy time
30 Hypertensive Drug Therapy time
31 Hypertensive Drug Therapy time
32 Hypertensive Drug Therapy time
33 Hypertensive Drug Therapy time
34 Can we use visualization tools to more accurately understand adherence patterns in hypertensive drug therapy?
35 Research Questions Can we identify good vs. bad patterns? Can we understand patient behavior? 11
36 Data Commercial prescription claims 900,000 individuals (16 million claims) 5 Drug Classes ACE ARB CCB Beta Diur Angiotension-Converting Enzyme-Inhibitors Angiotension II Receptor Blockers Calcium Channel Blockers Beta Blockers Diuretics 12
37 Data Simplification Partitioning Temporal Windowing Interval Merging 13
38 Data Simplification Partitioning Temporal Windowing Interval Merging Dataset 14
39 Data Simplification Partitioning Temporal Windowing Interval Merging Single } 2 Drugs } 3 Drugs } 4 Drugs All 5 14
40 Data Simplification Partitioning Temporal Windowing Interval Merging Start of record time 15
41 Data Simplification Partitioning Temporal Windowing Interval Merging Start of record 2 years time 15
42 Data Simplification Partitioning Temporal Windowing Interval Merging time 16
43 Data Simplification Partitioning Temporal Windowing Interval Merging time 16
44 How do allowable gap and overlap assumptions affect adherence analysis?
45 Sensitivity Analysis: Allowable Gap 0 days 7 days 15 days 30 days 18
46 Sensitivity Analysis: Allowable Gap 0 days 7 days 15 days 30 days 18
47 Sensitivity Analysis: Allowable Gap 0 days 7 days 15 days 30 days 18
48 Sensitivity Analysis: Allowable Gap 0 days 7 days 15 days 30 days 18
49 Sensitivity Analysis: Allowable Overlap 0 days 7 days 15 days 30 days 19
50 Sensitivity Analysis: Allowable Overlap 0 days 7 days 15 days 30 days 19
51 Sensitivity Analysis: Allowable Overlap 0 days 7 days 15 days 30 days 19
52 Sensitivity Analysis: Allowable Overlap 0 days 7 days 15 days 30 days 19
53 ACE Single Drugs ARB CCB Beta Diur 20
54 ACE Single Drugs ARB CCB Beta Diur 20
55 2 Drugs ACE Beta Both 21
56 2 Drugs ACE Beta Both 21
57 2 Drugs ACE Beta Both false overlap 22
58 2 Drugs ACE Beta Both 23
59 2 Drugs ACE Beta Both 24
60 All 5 Drugs 2,200 patients 25
61 All 5 Drugs 2,200 patients 26
62 All 5 Drugs 2,200 patients 26
63 All 5 Drugs 2,200 patients 26
64 All 5 Drugs 2,200 patients 26
65 All 5 Drugs 2,200 patients 27
66 All 5 Drugs 2,200 patients 27
67 ACE Starting on Diuretic 150,000 patients ARB CCB Beta Diur 28
68 ACE Starting on Diuretic 150,000 patients ARB CCB Beta Diur 28
69 ACE Starting on Diuretic 150,000 patients ARB CCB Beta Diur 28
70 Summary Visualization facilitated rapid understanding of complex patient behavior Interactions allow systematic analysis of episode modeling 29
71 Understanding Temporal Patterns in Hypertensive Drug Therapy Sana Malik Thanks to Sophia Wu. Support from the University of Maryland Center for Health-related Informatics and Bioimaging (CHIB). 30
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