a retrospective cohort analysis

Background Allergy immunotherapy is an effective treatment for patients with allergic rhinitis whose symptoms are unresolved with pharmacotherapy. Allergy immunotherapy for grass pollen-induced allergic rhinitis is available in three modalities: subcutaneous immunotherapy and sublingual immunotherapy as a tablet or drop. This study aimed to understand trends in allergy immunotherapy prescribing and practice patterns for grass allergies in adult and paediatric patients in Germany. Methods A retrospective cohort study was conducted using IMS Disease Analyzer in Germany. Patients with an allergy immunotherapy prescription for grass pollen (Anatomical Therapeutic Chemical [ATC] classification code V01AA02) from September 2005 to December 2012 were included in the study. General Practitioners (GPs), dermatologists, Ear, Nose and Throat (ENT)-specialists, paediatricians and pneumologists were included as the allergy immunotherapy prescribing physicians in the study. Descriptive analyses were conducted on patient characteristics at index and prescribing physician specialty; a test for trend was conducted for timing of initiation of first allergy immunotherapy prescription in each annual prescribing season. Results Eighteen thousand eight hundred fifty eligible patients were identified during the study period. The majority of patients received subcutaneous immunotherapy; however, the proportion of patients receiving sublingual immunotherapy tablets increased from 8 % in 2006/2007 to 29 % in 2011/2012 (p < 0.001). Initiation of subcutaneous immunotherapy and Oralair® generally peaked during each prescribing year in two seasons (September- October and January) while GRAZAX® prescriptions peaked in autumn (September- October). ENT-specialists and dermatologists were the largest allergy immunotherapy prescribers in adults, while paediatricians and ENT-specialists were the largest prescribers of allergy immunotherapy in paediatric patients. Conclusions Subcutaneous immunotherapy remained the dominant allergy immunotherapy modality for grass pollen-induced allergic rhinitis in Germany for adult and paediatric patients; however, there was a marked increase in proportion of patients receiving sublingual immunotherapy tablets from 2006/2007 to 2011/2012, after their introduction to the market in 2006. ENT- specialists, dermatologists and paediatricians were responsible for the majority of prescribing. The predominance of particular modalities within certain physician specialties likely reflects different treatment goals or needs

Physician-prescribed Asthma Treatment Regimen does not differ Between Smoking and Non-smoking Patients With Asthma in Seoul and Gyunggi province of Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ACKNOWLEDGMENTS The authors thank Lauren Weisenfluh and Melissa Stauffer, PhD, in collaboration with SCRIBCO, for medical writing assistance. Funding for this research was provided by Merck & Co., Inc. The authors also wish to thank Eric Maiese and Sharlette Everett for their contributions to the design and implementation of the study and the analytic plan. The authors would also like to thank the study investigators who contributed to patient enrollment and data collection: Drs. Young Il Hwang (Hallym University Sacred Heart Hospital), Young Min Ye (Ajou University Medical Center), Joo Hee Kim (Ajou University Medical Center), Heung Woo Park (Seoul National University Hospital), Tae Wan Kim (Seoul National University Hospital), Jae Jeong Shim (Korea University Guro Hospital), Gyu Young Hur (Korea University Guro Hospital), Soo Taek Uh (SoonChunHyang University Hospital), Sang Ha Kim (Wonju Christian Hospital), Myoung Kyu Lee (Wonju Christian Hospital), Soo Keol Lee (Dong-A Medical Center), Jin Hong Chung (Yeungnam University Medical Center), Kyu Jin Kim (Yeungnam University Medical Center), Young Koo Jee (Dankook University Hospital), Kyung Mook Kim (Dankook University Hospital), Young Il Koh (Chonnam National University Hospital), Cheol Woo Kim (Inha university Hospital), You Sook Cho (Seoul Asan Medical Center), Tae Bum Kim (Seoul Asan Medical Center), Jae Myung Lee (Myeong Internal Medicine), Young Mok Lee (Good Friends Internal Medicine), Bong Chun Lee (Namsan Hospital), So Yoen Park (A&A Clinic).Peer reviewedPublisher PD

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

Methods Aimed at Improving Asthma Care and Outcomes Management: A Case Study

Objectives: To compare the experience of one managed care organization (MCO) [Anthem Blue Cross and Blue Shield Midwest Region] to the experience of a reference group of 15 other MCOs participating in a study designed to test the usefulness of outcomes management information in developing and implementing interventions to improve the quality of care in asthma. Study design: Prospective study. Patients and methods: Adult patients with moderate or severe asthma enrolled in sixteen participating MCOs who completed an initial baseline survey in 1993 and follow-up surveys in 1994 and 1995. Data analyses focused on differences between Anthem and the reference group at each round of data collection as well as longitudinal analyses of changes over time. Results: Baseline data suggested some deficiencies in care at all MCO sites. Cross-sectional comparisons between Anthem and the reference group revealed statistically significant differences in outcomes measures (hospitalization and emergency room visits, canceled activities per month because of asthma, asthma attacks per month, and work days lost in the past month). Improvements in these outcomes were reported over the subsequent two years. Patients at Anthem reported a significantly greater increase in peak flow meter (PFM) possession than did those in the reference group (p = 0.01) which may have resulted from an administrative change that made PFMs a funded item. However, other interventions (e.g. educational programs) may have also contributed to the improvements. Conclusions: This study illustrates the ability of MCOs to collect and use patient-reported outcomes data to monitor and improve patient care. Such information allowed this national group of participating MCOs to identify deficiencies in quality of care provided, design tailored interventions and measure the potential impact of these interventions on patient care.Asthma, Managed care, Outcomes research, Pharmacoeconomics, Quality of care