Qian Cai

Publications (2)4.56 Total impact

• Article: Impact of positive airway pressure among obstructive sleep apnea patients.

  Qian Cai, Hiangkiat Tan, Joseph Singer
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  ABSTRACT: To evaluate the clinical and economic impact of positive airway pressure (PAP) among patients with obstructive sleep apnea (OSA). Retrospective claims-based analysis of OSA patients diagnosed with polysomnography (PSG) between January 1, 2005, and April 30, 2008. Patients were required to have 2 or more claims for OSA diagnosis within 1 year after their first PSG test, and a minimum of 12 months' baseline and 24 months' follow-up continuous health plan enrollment. Patients with pulmonary disease or PAP use before the first PSG test were excluded. Outcomes included all-cause and sleep apnea-related hospitalization and healthcare costs. Multivariable analyses were performed to adjust for baseline characteristics. Of the 15,424 patients identified, 90.7% used PAP and 9.3% did not. The PAP group had lower all-cause (19.0% vs 24.2%, P <.001) and sleep apnea-related (8.0% vs 11.3%, P <.001) hospitalization rates than the non-PAP group during the follow-up period. After adjusting for baseline characteristics, patients in the PAP group were less likely to have an all-cause (odds ratio [OR] 0.70; 95% confidence interval [CI] 0.61-0.80]) or sleep apnea-related (OR 0.69; 95% CI 0.58-0.83) hospitalization than non-PAP patients. PAP users on average incurred 10% lower all-cause costs than non-PAP patients ($705 per member per month vs $786 per member per month, P <.001) in multivariable analysis. Among OSA patients in real-world practice, PAP users had significantly lower hospitalization risks and all-cause healthcare costs.
  The American journal of managed care 01/2012; 18(6):e225-33. · 2.46 Impact Factor
• Source

  Available from: Judith J Stephenson

  Article: Impact of adherence to disease-modifying therapies on clinical and economic outcomes among patients with multiple sclerosis.

  Hiangkiat Tan, Qian Cai, Sonalee Agarwal, Judith J Stephenson, Siddhesh Kamat
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  ABSTRACT: Adherence to disease-modifying therapies (DMTs) is essential for the reduction of multiple sclerosis (MS) progression and relapse. However, only limited data currently exist on the impact of treatment adherence on MS-related clinical and economic outcomes in the real world setting. To assess the impact of treatment adherence on MS-related hospitalizations (inpatient [INP]), ER visits, MS relapses, and medical costs. Patients with ≥ 1 ICD-9-CM code for MS who received ≥ 1 DMT between July 1, 2004 and June 30, 2008 were identified using the administrative claims database. The first DMT received during the study period was defined as the index treatment and ≥ 6-month preindex and ≥ 12-month postindex continuous health-plan enrollment were required for inclusion. Adherence was assessed using the medication possession ratio (MPR); patients with MPR ≥ 80% were regarded as adherent. Multivariate analyses were used to evaluate the impact of adherence on MS-related outcomes after controlling for baseline demographic and clinical characteristics. In this cohort (n=2446), 59.6% of the patients were adherent to their DMT. Compared with the nonadherent group, adherent patients were significantly less likely to have MS-related INP (odds ratio [OR]: 0.63, 95% confidence interval [CI], 0.47-0.83) and MS relapses (OR: 0.71, 95% CI, 0.59-0.85). No significant difference was found in ER risk between adherent and nonadherent groups (8.4% vs. 10.5%, P=0.068, OR: 0.80, 95% CI: 0.60-1.07). On average, the adherent group incurred lower medical costs than the nonadherent group ($3380, 95% CI, $3046-$3750 vs. $4348, 95% CI, $3828-$4940, P=0.003). Treatment adherence is associated with better clinical and economic outcomes including lower risks for MS-related hospitalization, MS relapse, and less MS-related medical costs. Treatments that require infrequent administrations and have favorable adherence profiles may benefit patients who are unable to adhere to DMT therapies. Such treatments may be important in improving disease outcomes and may be suitable therapeutic candidates for the management of MS.
  Advances in Therapy 01/2011; 28(1):51-61. · 2.11 Impact Factor