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  • JAMA Internal Medicine April 1, 2016

    Figure 2: Trends in Percutaneous Coronary Intervention (PCI) Quality Metrics

    A, Proportion of primary PCI procedures with recording of hospital arrival time (P = .10) and balloon dilation time (P = .86). B, Proportion of documentation of PCI with missing procedural success indicators (P = .03) and successful procedures among PCIs with complete documentation of success indicators (P < .001). C, Proportion of PCI procedures with serum creatinine levels assessed before (P < .001) and after (P < .001) PCI, and cardiac biomarkers assessed after PCI (P = .64) (for the first PCI procedure if more than 1 procedure was performed during a hospitalization), as well as procedures with documentation of contrast volume (P < .001). D, Proportion of patients with missing discharge medications (P = .13) and documentation of statin (P < .001), aspirin (P < .001), and thienopyridine (clopidogrel or ticlopidine) use (P < .001) among patients with stents.
  • Changes in Prescription and Over-the-Counter Medication and Dietary Supplement Use Among Older Adults in the United States, 2005 vs 2011

    Abstract Full Text
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    JAMA Intern Med. 2016; 176(4):473-482. doi: 10.1001/jamainternmed.2015.8581

    In a nationally representative sample of older adults, this study characterizes changes in the prevalence of medication use and quantifies the frequency and types of potential major drug-drug interactions.

  • JAMA Internal Medicine January 1, 2015

    Figure 1: Association Among Bleeding Events, Treatment, and Patient Characteristics

    The hazard ratios (HRs) were estimated by Cox proportional hazards regression models with propensity score weighting. The number of other comorbidities has been calculated as the sum of previous history of acute myocardial infarction, Alzheimer disease, related disorders or senile dementia, anemia, asthma, benign prostatic hyperplasia, cataract, chronic obstructive pulmonary disease, congestive heart failure, depression, diabetes mellitus, ischemic heart disease, hip or pelvic fracture, glaucoma, hyperlipidemia, osteoporosis, rheumatoid arthritis or osteoarthritis, breast cancer, colorectal cancer, prostate cancer, lung cancer, and endometrial cancer. Nonsteroidal anti-inflammatory drugs (NSAIDs) include diclofenac, ibuprofen, naproxen, ketoprofen, fenoprofen, flurbiprofen, piroxicam, meloxicam, mefenamic acid, and indomethacin. Antiplatelet agents include aspirin, clopidogrel, prasugrel, dipyridamol, ticlopidine, and ticagrelor. The concurrent risk score was calculated with the use of an algorithm as described in the text; higher scores predict greater medical spending. CMS indicates Centers for Medicare & Medicaid Services; TIA, transient ischemic attack. Error bars indicate 95% CIs.
  • Chronicle of an Unforetold Death

    Abstract Full Text
    Arch Intern Med. 2012; 172(15):1174-1177. doi: 10.1001/archinternmed.2012.2204
  • The FDA's Defensive Status and How It Affects Patient Care

    Abstract Full Text
    Arch Intern Med. 2011; 171(13):1217-1217. doi: 10.1001/archinternmed.2011.291
  • National Estimates of Emergency Department Visits for Hemorrhage-Related Adverse Events From Clopidogrel Plus Aspirin and From Warfarin

    Abstract Full Text
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    Arch Intern Med. 2010; 170(21):1926-1933. doi: 10.1001/archinternmed.2010.407
  • Risk of Bleeding With Single, Dual, or Triple Therapy With Warfarin, Aspirin, and Clopidogrel in Patients With Atrial Fibrillation

    Abstract Full Text
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    Arch Intern Med. 2010; 170(16):1433-1441. doi: 10.1001/archinternmed.2010.271
  • Conflicting Evidence Surrounding the Clopidogrel and Proton Pump Inhibitor Drug Interaction

    Abstract Full Text
    Arch Intern Med. 2010; 170(16):1507-1508. doi: 10.1001/archinternmed.2010.299
  • Conflicting Evidence Surrounding the Clopidogrel and Proton Pump Inhibitor Drug Interaction—Reply

    Abstract Full Text
    Arch Intern Med. 2010; 170(16):1507-1508. doi: 10.1001/archinternmed.2010.300
  • JAMA Internal Medicine September 13, 2010

    Figure 2: Risk of Bleeding With Single, Dual, or Triple Therapy With Warfarin, Aspirin, and Clopidogrel in Patients With Atrial Fibrillation

    Proportion of patients with atrial fibrillation who had a prescription filled for warfarin, aspirin, or clopidogrel within 90 days of hospital discharge and the crude incidence rate of nonfatal and fatal bleeding (in percentage per patient-year) within 180 days of discharge.
  • JAMA Internal Medicine September 13, 2010

    Figure 3: Risk of Bleeding With Single, Dual, or Triple Therapy With Warfarin, Aspirin, and Clopidogrel in Patients With Atrial Fibrillation

    Hazard ratios (HRs) for the risk of nonfatal (n = 12 191) and fatal (n = 1381) bleeding associated with the use of warfarin, aspirin, clopidogrel, and combinations of these drugs. CI indicates confidence interval.
  • JAMA Internal Medicine September 13, 2010

    Figure 4: Risk of Bleeding With Single, Dual, or Triple Therapy With Warfarin, Aspirin, and Clopidogrel in Patients With Atrial Fibrillation

    Hazard ratios (HRs) for the risk of nonfatal (n = 9785) and fatal (n = 3537) ischemic stroke associated with the use of warfarin, aspirin, clopidogrel, and combinations of these drugs. CI indicates confidence interval.
  • JAMA Internal Medicine June 28, 2010

    Figure: Prasugrel and Cancer: An Uncertain Association or a Credible Risk That Meaningfully Alters the Benefit-Risk Balance

    Benefit-risk balance in the Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel–Thrombolysis in Myocardial Infarction 38 (TRITON–TIMI 38). Data are shown for every 1000 patients treated with prasugrel instead of clopidogrel. Clinically relevant myocardial infarction (MI) is based on all 3 criteria of ischemic chest pain, electrocardiographic changes, and biomarker elevation. TIMI major bleeding event: symptomatic intracranial hemorrhage or clinically overt bleeding with a 5-g/dL or more drop in hemoglobin level (to convert to grams per liter, multiply by 10); TIMI minor bleeding event: clinically overt bleeding with a 3- to 5-g/dL drop in hemoglobin level; TIMI minimal bleeding event: clinically overt bleeding with a less than 3-g/dL drop in hemoglobin level.
  • Risk of Rehospitalization for Patients Using Clopidogrel With a Proton Pump Inhibitor

    Abstract Full Text
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    Arch Intern Med. 2010; 170(8):704-710. doi: 10.1001/archinternmed.2010.34
  • Costs and Consequences of Direct-to-Consumer Advertising for Clopidogrel in Medicaid

    Abstract Full Text
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    Arch Intern Med. 2009; 169(21):1969-1974. doi: 10.1001/archinternmed.2009.320
  • JAMA Internal Medicine November 23, 2009

    Figure 1: Costs and Consequences of Direct-to-Consumer Advertising for Clopidogrel in Medicaid

    Estimated expenditure on direct-to-consumer advertising (DTCA) for clopidogrel from 1999 through 2005.
  • JAMA Internal Medicine November 23, 2009

    Figure 2: Costs and Consequences of Direct-to-Consumer Advertising for Clopidogrel in Medicaid

    Quarterly number of US national network news direct-to-consumer advertising for clopidogrel from the Vanderbilt Television News Archive from 1999 through 2005.
  • JAMA Internal Medicine November 23, 2009

    Figure 3: Costs and Consequences of Direct-to-Consumer Advertising for Clopidogrel in Medicaid

    The number of clopidogrel units per 1000 enrollees per quarter in 27 Medicaid programs from 1999 through 2005. The vertical line and the gray bar indicate the start of network news advertising in the fourth quarter of 2001. The solid lines represent the fitted interrupted time series analysis, and the dashed line represents the expected use rate based on the pre–direct-to-consumer advertising (DTCA) trend. The analysis indicated no statistically significant change in either the level (P = .18) or the trend (P = .10) after DTCA initiation.
  • JAMA Internal Medicine November 23, 2009

    Figure 4: Costs and Consequences of Direct-to-Consumer Advertising for Clopidogrel in Medicaid

    Pharmacy reimbursement per unit of clopidogrel per quarter in 27 Medicaid programs from 1999 through 2005. The vertical line and the gray bar indicate the start of network news advertising in the fourth quarter of 2001. The solid lines represent the fitted interrupted time series analysis, and the dashed line represents the expectation based on the pre–direct-to-consumer advertising (DTCA) trend. The analysis indicated a significant increase in level of $0.40 per unit after DTCA initiation (95% confidence interval, $0.31-$0.49; P < .001). It indicated no statistically significant change in the existing trend (P = .66).
  • JAMA Internal Medicine November 23, 2009

    Figure 5: Costs and Consequences of Direct-to-Consumer Advertising for Clopidogrel in Medicaid

    Total pharmacy reimbursement for clopidogrel per 1000 enrollees per quarter in 27 Medicaid programs from 1999 through 2005. The vertical line and the gray bar indicate the start of network news advertising in the fourth quarter of 2001. The solid lines represent the fitted interrupted time series analysis for the reimbursement rate, and the dashed line represents the expected rate had the pre–direct-to-consumer advertising (DTCA) trend continued. The analysis indicated a significant increase in trend of $40.58 (95% confidence interval, $22.61-$58.56; P < .001) per quarter after DTCA initiation.