Rate and predictors of treatment prescription for hepatitis C

Adeel A. Butt, Amy C. Justice, Melissa Skanderson, Michael O. Rigsby, Chester B. Good, Chian K Kwoh

Research output: Contribution to journalArticle

116 Citations (Scopus)

Abstract

Background: The true treatment rate for hepatitis C virus (HCV) in veterans is unknown. Aim: To determine the treatment prescription rates and predictors of treatment prescription for HCV in a large national population. Methods: The Department of Veterans Affairs National Patient Care Database (NPCD) was used to identify all HCV-infected people between the fiscal years 1999 and 2003 using the International classification of diseases, 9th revision codes. Demographic information, medical and psychiatric comorbidities, and drug and alcohol use diagnoses were retrieved. Pharmacy data were retrieved from the Department of Veterans Affairs Pharmacy Benefits Management (PBM) database. Logistic regression analysis was used to determine the predictors of treatment for HCV in HCV. Results: 113 927 veterans in the Department of Veterans Affairs care with a diagnosis of HCV were identified. The treatment prescription rate for HCV was 11.8%. Patients not prescribed treatment were older, more likely to be from minority races, have more alcohol and drug misuse, and have medical and psychiatric comorbid conditions. In a multivariate logistic regression model, the following factors were predictive of non-treatment for HCV: increasing age (odds ratio (OR) 0.77 for each 5-year increase in age; 95% confidence interval (CI) 0.76 to 0.78); black race (OR 0.64; 95% CI 0.6 to 0.68); Hispanic race (OR 0.88; 95% CI 0.8 to 0.96); alcohol abuse and dependence (OR 0.62; 95% CI 0.59 to 0.65); drug abuse and dependence (OR 0.78; 95% CI 0.74 to 0.82); anaemia (OR 0.18; 95% CI 0.16 to 0.21); hepatitis B infection (OR 0.72; 95% CI 0.62 to 0.83); coronary artery disease (OR 0.9; 95% CI 0.85 to 0.97); stroke (OR 0.75; 95% CI 0.67 to 0.85); bipolar disorder (OR 0.64; 95% CI 0.58 to 0.70); major depression (OR 0.72; 95% CI 0.67 to 0.77); mild depression (OR 0.56; 95% CI 0.53 to 0.59); and schizophrenia (OR 0.71; 95% CI 0.65 to 0.77). The following factors were associated with a higher likelihood of treatment prescription for HCV: liver cirrhosis (OR 1.6; 95% CI 1.5 to 1.7); and diabetes (OR 1.07; 95% CI 1.02 to 1.12). Conclusions: A small number of HCV-infected veterans were prescribed treatment for HCV. Non-treatment is associated with increasing age, non-white race, drug and alcohol abuse, and dependence and comorbid illnesses. Reasons for non-treatment need further study.

Original languageEnglish (US)
Pages (from-to)385-389
Number of pages5
JournalGut
Volume56
Issue number3
DOIs
StatePublished - Mar 2007
Externally publishedYes

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Hepatitis C
Prescriptions
Odds Ratio
Confidence Intervals
Hepacivirus
Veterans
Therapeutics
Alcoholism
Substance-Related Disorders
Logistic Models
Psychiatry
Alcohols
Databases
Depression
International Classification of Diseases
Hepatitis B
Bipolar Disorder
Hispanic Americans
Liver Cirrhosis
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Butt, A. A., Justice, A. C., Skanderson, M., Rigsby, M. O., Good, C. B., & Kwoh, C. K. (2007). Rate and predictors of treatment prescription for hepatitis C. Gut, 56(3), 385-389. https://doi.org/10.1136/gut.2006.099150

Rate and predictors of treatment prescription for hepatitis C. / Butt, Adeel A.; Justice, Amy C.; Skanderson, Melissa; Rigsby, Michael O.; Good, Chester B.; Kwoh, Chian K.

In: Gut, Vol. 56, No. 3, 03.2007, p. 385-389.

Research output: Contribution to journalArticle

Butt, AA, Justice, AC, Skanderson, M, Rigsby, MO, Good, CB & Kwoh, CK 2007, 'Rate and predictors of treatment prescription for hepatitis C', Gut, vol. 56, no. 3, pp. 385-389. https://doi.org/10.1136/gut.2006.099150
Butt AA, Justice AC, Skanderson M, Rigsby MO, Good CB, Kwoh CK. Rate and predictors of treatment prescription for hepatitis C. Gut. 2007 Mar;56(3):385-389. https://doi.org/10.1136/gut.2006.099150
Butt, Adeel A. ; Justice, Amy C. ; Skanderson, Melissa ; Rigsby, Michael O. ; Good, Chester B. ; Kwoh, Chian K. / Rate and predictors of treatment prescription for hepatitis C. In: Gut. 2007 ; Vol. 56, No. 3. pp. 385-389.
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abstract = "Background: The true treatment rate for hepatitis C virus (HCV) in veterans is unknown. Aim: To determine the treatment prescription rates and predictors of treatment prescription for HCV in a large national population. Methods: The Department of Veterans Affairs National Patient Care Database (NPCD) was used to identify all HCV-infected people between the fiscal years 1999 and 2003 using the International classification of diseases, 9th revision codes. Demographic information, medical and psychiatric comorbidities, and drug and alcohol use diagnoses were retrieved. Pharmacy data were retrieved from the Department of Veterans Affairs Pharmacy Benefits Management (PBM) database. Logistic regression analysis was used to determine the predictors of treatment for HCV in HCV. Results: 113 927 veterans in the Department of Veterans Affairs care with a diagnosis of HCV were identified. The treatment prescription rate for HCV was 11.8{\%}. Patients not prescribed treatment were older, more likely to be from minority races, have more alcohol and drug misuse, and have medical and psychiatric comorbid conditions. In a multivariate logistic regression model, the following factors were predictive of non-treatment for HCV: increasing age (odds ratio (OR) 0.77 for each 5-year increase in age; 95{\%} confidence interval (CI) 0.76 to 0.78); black race (OR 0.64; 95{\%} CI 0.6 to 0.68); Hispanic race (OR 0.88; 95{\%} CI 0.8 to 0.96); alcohol abuse and dependence (OR 0.62; 95{\%} CI 0.59 to 0.65); drug abuse and dependence (OR 0.78; 95{\%} CI 0.74 to 0.82); anaemia (OR 0.18; 95{\%} CI 0.16 to 0.21); hepatitis B infection (OR 0.72; 95{\%} CI 0.62 to 0.83); coronary artery disease (OR 0.9; 95{\%} CI 0.85 to 0.97); stroke (OR 0.75; 95{\%} CI 0.67 to 0.85); bipolar disorder (OR 0.64; 95{\%} CI 0.58 to 0.70); major depression (OR 0.72; 95{\%} CI 0.67 to 0.77); mild depression (OR 0.56; 95{\%} CI 0.53 to 0.59); and schizophrenia (OR 0.71; 95{\%} CI 0.65 to 0.77). The following factors were associated with a higher likelihood of treatment prescription for HCV: liver cirrhosis (OR 1.6; 95{\%} CI 1.5 to 1.7); and diabetes (OR 1.07; 95{\%} CI 1.02 to 1.12). Conclusions: A small number of HCV-infected veterans were prescribed treatment for HCV. Non-treatment is associated with increasing age, non-white race, drug and alcohol abuse, and dependence and comorbid illnesses. Reasons for non-treatment need further study.",
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T1 - Rate and predictors of treatment prescription for hepatitis C

AU - Butt, Adeel A.

AU - Justice, Amy C.

AU - Skanderson, Melissa

AU - Rigsby, Michael O.

AU - Good, Chester B.

AU - Kwoh, Chian K

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N2 - Background: The true treatment rate for hepatitis C virus (HCV) in veterans is unknown. Aim: To determine the treatment prescription rates and predictors of treatment prescription for HCV in a large national population. Methods: The Department of Veterans Affairs National Patient Care Database (NPCD) was used to identify all HCV-infected people between the fiscal years 1999 and 2003 using the International classification of diseases, 9th revision codes. Demographic information, medical and psychiatric comorbidities, and drug and alcohol use diagnoses were retrieved. Pharmacy data were retrieved from the Department of Veterans Affairs Pharmacy Benefits Management (PBM) database. Logistic regression analysis was used to determine the predictors of treatment for HCV in HCV. Results: 113 927 veterans in the Department of Veterans Affairs care with a diagnosis of HCV were identified. The treatment prescription rate for HCV was 11.8%. Patients not prescribed treatment were older, more likely to be from minority races, have more alcohol and drug misuse, and have medical and psychiatric comorbid conditions. In a multivariate logistic regression model, the following factors were predictive of non-treatment for HCV: increasing age (odds ratio (OR) 0.77 for each 5-year increase in age; 95% confidence interval (CI) 0.76 to 0.78); black race (OR 0.64; 95% CI 0.6 to 0.68); Hispanic race (OR 0.88; 95% CI 0.8 to 0.96); alcohol abuse and dependence (OR 0.62; 95% CI 0.59 to 0.65); drug abuse and dependence (OR 0.78; 95% CI 0.74 to 0.82); anaemia (OR 0.18; 95% CI 0.16 to 0.21); hepatitis B infection (OR 0.72; 95% CI 0.62 to 0.83); coronary artery disease (OR 0.9; 95% CI 0.85 to 0.97); stroke (OR 0.75; 95% CI 0.67 to 0.85); bipolar disorder (OR 0.64; 95% CI 0.58 to 0.70); major depression (OR 0.72; 95% CI 0.67 to 0.77); mild depression (OR 0.56; 95% CI 0.53 to 0.59); and schizophrenia (OR 0.71; 95% CI 0.65 to 0.77). The following factors were associated with a higher likelihood of treatment prescription for HCV: liver cirrhosis (OR 1.6; 95% CI 1.5 to 1.7); and diabetes (OR 1.07; 95% CI 1.02 to 1.12). Conclusions: A small number of HCV-infected veterans were prescribed treatment for HCV. Non-treatment is associated with increasing age, non-white race, drug and alcohol abuse, and dependence and comorbid illnesses. Reasons for non-treatment need further study.

AB - Background: The true treatment rate for hepatitis C virus (HCV) in veterans is unknown. Aim: To determine the treatment prescription rates and predictors of treatment prescription for HCV in a large national population. Methods: The Department of Veterans Affairs National Patient Care Database (NPCD) was used to identify all HCV-infected people between the fiscal years 1999 and 2003 using the International classification of diseases, 9th revision codes. Demographic information, medical and psychiatric comorbidities, and drug and alcohol use diagnoses were retrieved. Pharmacy data were retrieved from the Department of Veterans Affairs Pharmacy Benefits Management (PBM) database. Logistic regression analysis was used to determine the predictors of treatment for HCV in HCV. Results: 113 927 veterans in the Department of Veterans Affairs care with a diagnosis of HCV were identified. The treatment prescription rate for HCV was 11.8%. Patients not prescribed treatment were older, more likely to be from minority races, have more alcohol and drug misuse, and have medical and psychiatric comorbid conditions. In a multivariate logistic regression model, the following factors were predictive of non-treatment for HCV: increasing age (odds ratio (OR) 0.77 for each 5-year increase in age; 95% confidence interval (CI) 0.76 to 0.78); black race (OR 0.64; 95% CI 0.6 to 0.68); Hispanic race (OR 0.88; 95% CI 0.8 to 0.96); alcohol abuse and dependence (OR 0.62; 95% CI 0.59 to 0.65); drug abuse and dependence (OR 0.78; 95% CI 0.74 to 0.82); anaemia (OR 0.18; 95% CI 0.16 to 0.21); hepatitis B infection (OR 0.72; 95% CI 0.62 to 0.83); coronary artery disease (OR 0.9; 95% CI 0.85 to 0.97); stroke (OR 0.75; 95% CI 0.67 to 0.85); bipolar disorder (OR 0.64; 95% CI 0.58 to 0.70); major depression (OR 0.72; 95% CI 0.67 to 0.77); mild depression (OR 0.56; 95% CI 0.53 to 0.59); and schizophrenia (OR 0.71; 95% CI 0.65 to 0.77). The following factors were associated with a higher likelihood of treatment prescription for HCV: liver cirrhosis (OR 1.6; 95% CI 1.5 to 1.7); and diabetes (OR 1.07; 95% CI 1.02 to 1.12). Conclusions: A small number of HCV-infected veterans were prescribed treatment for HCV. Non-treatment is associated with increasing age, non-white race, drug and alcohol abuse, and dependence and comorbid illnesses. Reasons for non-treatment need further study.

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