Documented tuberculin skin testing among infliximab users following a multi-modal risk communication interventions
Authors
Shatin, DeborahRawson, Nigel S.
Curtis, Jeffrey R.
Braun, M. Miles
Martin, Carolyn K.
Moreland, Larry W.
Becker, Angela F.
Patkar, Nivedita M.
Allison, Jeroan J.
Saag, Kenneth G.
UMass Chan Affiliations
Department of Quantitative Health SciencesDocument Type
Journal ArticlePublication Date
2005-09-02Keywords
AdultAntibodies, Monoclonal
Antirheumatic Agents
Female
Humans
*Information Dissemination
Male
Middle Aged
Risk
Tuberculin Test
Tuberculosis, Pulmonary
Tumor Necrosis Factor-alpha
Bioinformatics
Biostatistics
Epidemiology
Health Services Research
Metadata
Show full item recordAbstract
PURPOSE: Following its licensure, tuberculosis (TB) was reported as a potential adverse effect of infliximab. Subsequently, the product circular was changed to recommend tuberculin skin testing before patients received infliximab, which was reinforced by several risk communication efforts. The aim of this study was to evaluate patterns and predictors of documented tuberculin skin testing in patients before and after manufacturer, federal, and academic risk communications. METHODS: Patients administered infliximab were identified from 11 health plans located throughout the United States, and claims data were examined to determine whether the patients had received a tuberculin skin test. Patients were divided into three cohorts depending on the timing of their first infliximab treatment in relation to the risk communication efforts. RESULTS: The overall tuberculin skin testing rate doubled from 15.4% in the first cohort to 30.9% in the last cohort, while the rate of pre-infliximab treatment testing increased from 0 to 27.7% (Chi-squared test for trend, p < 0.0001 for both). Tuberculin skin testing rates were significantly higher in women, those with a diagnosis of rheumatoid or psoriatic arthritis, and those with a rheumatologist as prescriber. After multivariable analysis, only rheumatologist remained significantly associated with tuberculin skin testing. CONCLUSIONS: Although the tuberculin skin testing rate was relatively low overall, tuberculin skin testing doubled over 30 months of ongoing risk communication efforts and under ascertainment likely occurred. We also found variation in the tuberculin skin testing rate associated with physician specialty. This study demonstrates a significant change in patient care following risk communication efforts.Source
Pharmacoepidemiol Drug Saf. 2006 Jan;15(1):11-8. Link to article on publisher's siteDOI
10.1002/pds.1132Permanent Link to this Item
http://hdl.handle.net/20.500.14038/47671PubMed ID
16136625Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1002/pds.1132