Rajesh Balkrishnan

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..However, costs and efficacies of these therapies vary widely. Objective: To determine relative cost-effectiveness of common therapeutic regimens using published data...

..Unfortunately, coverage policies for psoriasis therapies do not necessarily follow current treatment paradigms, such that more expensive second or third line treatments may be more easily obtained than first line treatments...

..Education efforts and novel preparations of Class I agents will help to ensure the best possible care for patients suffering from significant skin diseases like psoriasis...

..Visible facial skin lesions are a common condition. Purpose This study assessed factors associated with health-related quality of life (HRQOL) in women with visible facial skin lesions...

..There is still a need for the development of safe and effective treatments for patients with moderate-to-severe psoriasis...

..In a study of 30 patients with moderate to severe hand dermatitis, we found 2 extremes of adherence behavior: overusage and underusage. We compared these 2 patients to one patient who engaged in near-ideal usage of medication...

..However, few data exist about adherence rates to home phototherapy, adding to concerns about the appropriateness of home phototherapy as a psoriasis treatment option...

..The decreasing role of dermatologists in the treatment of psoriasis is probably a complex issue, but may relate in part to the difficulty of obtaining access to dermatology care...

..Adherence to topical treatment of atopic dermatitis has not been well characterized. Poor adherence to topical medication could account for failure of topical therapy...

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..Pigmentary disorders are commonly seen in dermatology practice and can have a negative psychosocial impact on patients...

..Because of the high cost of treatment failures, access to a wide array of therapies and combination regimens should not be discouraged by physicians or insurers...

..This study examined which AK therapy was preferred among dermatologists and primary care physicians (PCPs), as well as potential determinants of therapeutic selection...

..Physicians and policy-makers should be aware of the role that this medication plays in the delivery of dermatologic care...

..Targeting parents and caregivers with education and psychosocial support can decrease family and personal burden, which in turn may decrease the cost of treating the condition because of better medical, psychosocial, and family outcomes...

..Incident reporting and public availability of incidents are important, as is standardization of reporting rules for both adverse events and number of procedures performed in different settings...

..Although the results reported herein are from a small exploratory study, the magnitude of the effect was sufficiently large as to be detectable with statistical significance (P<.05)...

..There are socioeconomic, cognitive, and psychological factors that contribute to non-adherence among patients. Improving patient knowledge and the doctor-patient relationship are ways to improve patient adherence...

..Collection of cost data needs to be incorporated into clinical trials to facilitate these decisions...

..Rosacea is an extremely common chronic dermatosis affecting an estimated 14 million Americans. Rosacea is most commonly managed with topical metronidazole, sometimes in combination with oral antibiotics...

..Currently, there is a difference in reimbursement between excision of malignant and benign lesions. There is concern that there is not sufficient rationale for differential reimbursement for these two procedures...

..In addition, the efficacy and safety profile of home ultraviolet B phototherapy make it an excellent choice for extended management...

..The objective of this study was to test the hypothesis that poorer patients in outpatient clinics are more likely to see PAs than physicians...

..This study examined the relationship between patient waiting time and willingness to return for care and patient satisfaction ratings with primary care physicians...

..Through informed discussion, the clinician can help each individual patient decide which biologic agent is ideal for them...

..Few controlled trials directly comparing use to non-use of a WAP were found. WAPs show promise in improving adherence in pediatric asthma, and their effect on adherence in pediatric atopic dermatitis is worthy of further investigation...

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..Given the acute nature of psoriasis inpatient episodes, the risks associated with long-term use of a treatment are far less important in inpatient setting treatment planning than they are in the outpatient setting...

..These findings raise the concern that incentive structures in the United States healthcare system do not adequately support delivery of dermatologic care for psoriasis. Efforts to promote psoriasis care should be encouraged...

..We conclude that adapting existing electronic monitors to medication tubes should facilitate a much better understanding of adherence to topical treatment...

..To assess which measures are utilized to quantify lesions, disease severity, and quality of life in the current literature on psoriasis vulgaris...

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..CONCLUSION: There has been a shift towards non-antibiotic treatment in acne management. Growing awareness of antibiotic-resistant Propionibacterium species may contribute to increased use of topical and systemic retinoid agents...

..As there was a lack of significant trends in this study, formal inferences are limited and further investigation is warranted...

..Patients may also vary in how thickly they apply topical medication. CONCLUSIONS: A simple guideline for how much topical corticosteroid to prescribe may facilitate the treatment of young children with skin disease...

..Copayments for phototherapy may be shifting patients toward biologic treatment, which is more convenient but more costly to managed care plans...

..CONCLUSION: A data logger can accurately capture usage patterns for a home phototherapy unit. These devices could potentially be used in clinical trials to measure adherence to home phototherapy treatment regimens...

..001). These findings suggest that BTX injections may be associated with beneficial outcomes in childhood spasticity...

..0001), and total costs (-$6,529, p < .0001; -$5,329, p <.0001, respectively). Adherence to hydroxyurea among SCD patients appears suboptimal and better adherence is associated with improved clinical and economic outcomes...

..This research was performed to better understand the physician and patient characteristics associated with the prescription of this combination medication in outpatient settings...

..Various systems are already in place in inpatient settings. Objective: To review existing medication error reporting systems related to outpatient settings with emphasis on topical medications associated with dermatological diseases...

..Traditional medication adherence monitoring for topical medication use in dermatology relies heavily on measures of self-reporting and ointment tube weight, which are susceptible to various biases...

..The purpose of this investigation was to examine whether prescribing patterns of a nationally representative sample of US physicians shed light on the incidence of use of topical retinoids for indications other than acne...

..Nonadherence to prescribed medications is a common problem in dermatology, and assessing adherence can be difficult. Electronic monitors are not always practical, but self-report measures may be less reliable...

..By understanding and manipulating the factors that affect treatment adherence, improvement in adherence is possible and hence better control and outcomes in the topical treatment of psoriasis are likely...

..Differences in age are associated with differences in pharmaceutical treatment as well as total healthcare utilization. Depression is a substantial comorbidity and patients seeking treatment of acne should be screened for depression...

..It is possible that the prognostic significance of omission of RT in clinical trials underestimates the significance of risk in the community...

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..An exploratory analysis of change in impact on families dealing with AD before and after an episode of medical care in a physician office setting was conducted...

..Historically, daily insulin treatment has been viewed as burdensome to patients, prompting newer formulations and improved delivery methods...

..It is disturbing to think that the deaths observed here could, at least in part, be prevented with the appropriate use of treatments...

..The secondary objective was to investigate perceptions about and patterns of herbal use...

..In addition differences among the TZDs with respect to these outcomes were examined...

..These data suggest that BTX therapy does not significantly add to the costs of treating Medicaid-enrolled children with CP...

..Pharmacologic therapy for glaucoma consists mainly of topical eye drops containing beta-blockers or prostaglandin analogs...

..This study examines the association between patient-physician encounters in such critical medical situations and patients' trust in their physician and in the medical profession in general...

..Routine monitoring of patient-centered self-care outcomes could help improve long-term outcomes of diabetes care in this population...

..Overregulation or loss of office surgery would have a tremendous impact on the management of skin cancers and the delivery of quality cosmetic and laser surgery...

..To examine the relationship between self-reported health status, prophylactic medication use, and healthcare service use in older adults with asthma...

..CONCLUSION: Willingness to pay for relief from skin diseases is comparable to that for relief of other serious medical conditions. Skin diseases are associated with a significant adverse impact on patients' lives...

..Rural and non-rural, young, school-aged children exhibit many similarities in healthcare utilization, but differences occur. Most surprising is the difference in the diagnosis frequency of attention deficit disorder...

..In a multivariate model, only perceived impact of the disability remained significant...

..The primary message of the campaign was "Talk to your kids about sex. Everyone else is."..

..At 3 months, there was a 30% improvement in Skindex-16 score (P < .001). The corrective cosmetic was well tolerated and represents a valuable option that dermatologists can offer to patients with these conditions...

..CONCLUSION: Patients with palmoplantar psoriasis are affected to a greater degree by the physical aspects of the disease than patients without palmoplantar involvement...

..Botulinum A toxin, when used in appropriate doses, is well tolerated...

..It is the most common form of cancer in the United States, more common than all other cancers combined. To determine the contributors to the cost of NMSC care, an episode of care of NMSC needed to be defined...

..Programs are needed to enhance communication effectiveness with Latino patients. We examined the effect of language immersion training for pediatric faculty on their communication with Latino patients...

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..To test the hypothesis that capitation payment to physicians reduces the length of physician-patient encounters but increases use of preventive and health counseling services...

..Parents who believed that their children receive enough care may need to be targeted for care management and disease management programs to ensure the continuum of treatment and care for these children...

..General physician trust potentially has a strong influence on important behaviors and attitudes, and on the formation of interpersonal physician trust...

..These parent caregiver factors may be important in identifying suitable audiences and areas for education for optimal management of children's AD...

..Moreover, an interdisciplinary agenda is necessary to set the stage for bringing together researchers from various disciplines and backgrounds with both participants and community representatives...

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..Because of recent press reports of adverse outcomes, office-based cosmetic surgery has come under intense scrutiny and associated legislative regulatory action...

..Even though melasma is prevalent in Hispanic women, its impact on health-related quality of life (HRQOL) has been under-reported. The purpose of this review is to evaluate the impact of melasma on the HRQOL of Hispanic women...

..Latanoprost, a prostaglandin inhibitor, is increasingly being used in the therapeutic management of glaucoma. However, there is scant literature examining the cost and outcome ramifications of latanoprost...

..This study examined association between depressive symptoms and Glaucoma medication-related persistence and predictors of associated healthcare charges in older adults with primary open angle Glaucoma...

..Few studies document differences in patient satisfaction with physicians in the elderly (> or = 65 years) and compare it to non-elderly (<65 years) patients...

..Clinical, health, and economic outcomes in patients with type 2 diabetes may be influenced by self-management behaviors and type of pharmacotherapy...

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..Thiazolidinediones (TZDs) are a newer class of agents used for the treatment of type 2 DM. No previous study has compared health care utilization associated with the 2 TZDs on the market...

..Correlations are equivalent with lack of disputes, length of relationship, and number of visits [corrected]...

..We examined the relationship between self-reported health status data, subsequent antimuscarinic medication adherence and health care service use in older adults with OAB syndrome in a managed care setting...

..Further investigation is needed to determine whether PIT improves generic measures of HRQL...

..Outcomes in asthmatic patients may vary depending on the controller medication used. Observational studies of outcomes of asthma therapy are needed to understand the implications of choice of controller in different populations...

..Attendance at diabetes educational sessions in primary care settings coupled with maintenance of blood glucose control seem to be associated with greatest risk reduction...

..0% higher than average scores vs patients using no medications, P = .006). CONCLUSIONS: We observed an association with topical corticosteroids for treatment of psoriasis on health care outcomes and costs...

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..The ability to change physicians seems to increase trust in the insurer...

..However, little is known about how similar or different these types of trust are in reality and the relationship of trust with satisfaction...

..In addition, there was a possible association between the age and ethnicity of patients with insomnia/sleep difficulties and the prescribing of expensive medications for sleep difficulties...

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..Biologics had a better adherence rate compared with other psoriasis medications...

..The purpose of this study is to analyze variables associated with consumer's satisfaction that they have enough choice when selecting their primary care provider (PCP), and to analyze the importance of these variables on provider trust...

..This study examined the physician and patients related factors associated with physician recommendations for breast cancer screening in the United States (US) outpatient settings...