17 May
The death of former President Ronald Reagan, who suffered for 10 years with Alzheimer’s disease (AD), came almost exactly one month after hearings held by a Senate committee on federal funding of AD research. The May 11 session was hardly noticed at the time, of course. The key point made by Stephen McConnell, senior vice president for advocacy and public policy at the Alzheimer’s Association, was that the National Institute of Aging (NIA), because of budget shortfalls, was tightening the funding flow for research on AD.
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15 May
Variations in the prescribing profiles and in the level of glycemic control, as measured by HbA1c, existed for the three hospital sites within VISN 4 of the VA health care system. Variations in practice patterns have been shown for multiple conditions, including treatment of diabetes mellitus. At the time of this study, national VA guidelines for the management of diabetes were in use and no separate guidelines existed for VISN 4. In addition to the guidelines, site-specific information focusing on levels of glycemic control and the percentage of patients with HbA1c levels below 8% was available to each institution.
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14 May
Demographics and Prescribing Profiles
Overall, 4,265 patients met the study’s eligibility criteria: 1,363 patients (32%) from site A; 2,188 patients (51%) from site B; and 714 patients (17%) from site C. As expected in a VA population, most patients at all sites were elderly and male (Table 1). The two academic sites (sites A and B) consisted of a higher proportion of African-American patients and fewer patients who were married at the time.
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13 May
We conducted a multicenter, retrospective cohort study at three VA hospitals in Pennsylvania using data for patients who received outpatient prescriptions for the treatment of diabetes mellitus during the 1997 calendar year. Two academic urban referral hospitals (sites A and B) and one rural community hospital (site C) were included. This study was designed to determine whether the primary care provider type and the site influenced diabetes-related outpatient pharmaceutical costs and glycemic control.
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12 May
INTRODUCTION
Diabetes mellitus is a prevalent condition that imparts a heavy toll on the health of affected individuals. This illness affects an estimated 6% of the U.S. population and approximately 12% of patients within the Veterans Affairs (VA) medical system.
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11 May
AOMT primarily affects young children. Caregivers of children with AOMT are usually parents, family members, or the legal guardians of the sick child. The initial decision to seek treatment usually rests solely with the caregiver.
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10 May
Demographic Comparisons
Sex. There were no statistical sex differences between the treatment groups. Table 2 presents the demographics of each treatment group.
Age. There were no statistical differences in age between the two treatment groups. The overall (pooled) mean age for all of the AOMT patients was 2.72 years (with a standard deviation [SD] of 2.47). The mean age of the Cdex treatment group was 2.77 years (SD, 2.53), with a 95% confidence interval (CI) of 2.43 to 3.10 years. In contrast, the mean age of the Oflx group was 2.68 years (SD, 2.42), with a 95% CI of 2.35 to 3.00 years.
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