J Avorn
Dados Biográficos
| ID | 2413041 |
|---|---|
| NOME | J Avorn |
| PRENOMES | J |
| SOBRENOME | Avorn |
| ASSINATURA | AVORN J |
| AFILIAÇÕES | Brigham and Women's Hospital |
| ORCID | 0000-0003-0255-2346 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 34 |
| TOTAL DE CITAÇÕES | 53 |
| TOTAL COMO AUTOR | 34 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1973 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2025 |
| ÍNDICE H | 3 |
Physician Perspectives on Pharmaceutical Promotion
This survey study reports the responses of medical students and residents about their interactions with and attitudes toward the pharmaceutical industry and changes over 13 years, from 2011 to 2024
Prescribing decision making by medical residents on night shifts
The Potential Return on Public Investment in Detecting Adverse Drug Effects
BACKGROUND: Many countries lack fully functional pharmacovigilance programs, and public budgets allocated to pharmacovigilance in industrialized countries remain low due to resource constraints and competing priorities. OBJECTIVE: Using 3 case examples, we sought to estimate the public health and economic benefits resulting from public investment in active pharmacovigilance programs to detect adverse drug effects. RESEARCH DESIGN: We assessed 3 e…
Equity in the Receipt of Oseltamivir in the United States During the H1N1 Pandemic
Objectives. We assessed the relationship between individual characteristics and receipt of oseltamivir (Tamiflu) in the United States during the H1N1 pandemic and other flu seasons. Methods. In a cohort of individuals enrolled in pharmacy benefit plans, we used a multivariate logistic regression model to measure associations between subscriber characteristics and filling a prescription for oseltamivir during 3 flu seasons (October 2006–May 2007, …
Unintended Consequences of a Medicaid Prescription Copayment Policy
BACKGROUND AND OBJECTIVES: Medication copayments can influence patient choices. We evaluated 2 copayment policies implemented by Massachusetts Medicaid incentivizing the use of selected generic medications. RESEARCH DESIGN AND MEASURES: In 2009, Massachusetts Medicaid copayments were $1 for generics and $3 for brands. On February 1, 2009, copayments for generic antihypertensives, antihyperlipidemics, and hypoglycemics (target medications) remaine…
Warnings Without Guidance
BACKGROUND: In January 2008, the Food and Drug Administration (FDA) communicated concerns about the efficacy of ezetimibe, but did not provide clear clinical guidance, and substantial media attention ensued. We investigated the proportion of patients who discontinued therapy and switched to a clinically appropriate alternative after the FDA communication. METHODS: Using claims data from a national pharmacy benefits manager, we created a rolling c…
Patient, Physician, and Payment Predictors of Statin Adherence
BACKGROUND: Although many patient, physician, and payment predictors of adherence have been described, knowledge of their relative strength and overall ability to explain adherence is limited. OBJECTIVES: To measure the contributions of patient, physician, and payment predictors in explaining adherence to statins. RESEARCH DESIGN: Retrospective cohort study using administrative data. SUBJECTS: A total of 14,257 patients insured by Horizon Blue Cr…
An Evaluation of the Relationship Between the Implementation of a Newly Designed Prescription Drug Label at Target Pharmacies and Health Outcomes
BACKGROUND: Medication errors represent a major public health concern, and inadequate prescription drug labels have been identified as a root cause of errors. A new prescription medication labeling system was implemented by Target pharmacies in May 2005 and aimed to improve health outcomes. OBJECTIVES: To evaluate whether the new Target label influenced patient health services utilization. SUBJECTS: Derived from 2 large health plans. RESEARCH DES…
Is There a Relationship Between Patient Beliefs or Communication About Generic Drugs and Medication Utilization
BACKGROUND: Insurers and policymakers strive to stimulate more cost-effective prescribing and, increasingly, are educating beneficiaries about generics. OBJECTIVES: To evaluate the relationship between patient beliefs and communication about generic drugs and actual drug use. RESEARCH DESIGN AND SUBJECTS: We performed a national mailed survey of a random sample of 2500 commercially-insured adults. Patient responses were linked to pharmacy claims …
Design of Cluster-Randomized Trials of Quality Improvement Interventions Aimed at Medical Care Providers
BACKGROUND: Randomized trials aimed at improving the quality of medical care often randomize the provider. Such trials are frequently embedded in health care systems with available automated records, which can be used to enhance the design of the trial. METHODS: We consider how available information from automated records can address each of the following concerns in the design of a trial: whether to randomize individual providers or practices; c…
The Medical License Number Accurately Identifies the Prescribing Physician in a Large Pharmacy Claims Database
BACKGROUND: Medical license numbers that identify physicians in pharmacy claims data are used increasingly for both research and quality improvement efforts; however, little is known about how well this information identifies the physician who wrote the prescription. We studied the accuracy of the medical license number in data from a state-run drug benefit plan by assessing its consistency with 2 external sources of data. METHODS: We studied a c…
Increasing Levels of Restriction in Pharmacoepidemiologic Database Studies of Elderly and Comparison With Randomized Trial Results
BACKGROUND: The goal of restricting study populations is to make patients more homogeneous regarding potential confounding factors and treatment effects and thereby achieve less biased effect estimates. OBJECTIVES: This article describes increasing levels of restrictions for use in pharmacoepidemiology and examines to what extent they change rate ratio estimates and reduce bias in a study of statin treatment and 1-year mortality. METHODS: : The s…
Adjustments for Unmeasured Confounders in Pharmacoepidemiologic Database Studies Using External Information
BACKGROUND: Nonexperimental studies of drug effects in large automated databases can provide timely assessment of real-life drug use, but are prone to confounding by variables that are not contained in these databases and thus cannot be controlled. OBJECTIVES: To describe how information on additional confounders from validation studies can help address the problem of unmeasured confounding in the main study. RESEARCH DESIGN: Review types of vali…
Variable Selection for Propensity Score Models
Despite the growing popularity of propensity score (PS) methods in epidemiology, relatively little has been written in the epidemiologic literature about the problem of variable selection for PS models. The authors present the results of two simulation studies designed to help epidemiologists gain insight into the variable selection problem in a PS analysis. The simulation studies illustrate how the choice of variables that are included in a PS m…
Educating Trainees about the Cost of Medications
Medical students and residents should be taught about the cost of prescription medication, how these costs affect patient compliance, and how they can help alleviate the financial burden of prescription drugs. Virtual Mentor is a monthly bioethics journal published by the American Medical Association
Prior Authorization Policies for Selective Cyclooxygenase-2 Inhibitors in Medicaid
BACKGROUND: Many state Medicaid programs use prior authorization programs to limit spending on cyclooxygenase-2 selective nonsteroidal anti-inflammatory drugs (coxibs). However, the evidence base for the prior authorization criteria has not been examined previously. METHODS: We determined whether prior authorization was required for coxibs in state Medicaid programs and collected data on what precise criteria needed to be met for a coxib prescrip…
Trends in Knee Magnetic Resonance Imaging
OBJECTIVE: To assess trends in knee magnetic resonance imaging (MRI) use and accompanying management changes to determine whether indications for this test have changed over time. DATA SOURCES: Large administrative database containing health care information for 587,010 people living in 1 state who were enrolled in the Medicare or Medicaid programs. They all had used health services during 3 consecutive years between 1991 to 1995. METHODS: We per…
Patient Noncompliance in the Managed Care Setting
OBJECTIVES: The authors identify demographic and clinical characteristics associated with noncompliance in patients beginning medical therapy for the treatment of glaucoma in a managed care setting. METHODS: The authors describe a retrospective cohort study in a group-model health maintenance organization in Massachusetts. Patients were members of the health maintenance organization who were newly initiated on topical drug therapy to treat open-a…
Policy Analysis of the Conversion of Histamine2 Antagonists to Over-the-Counter Use
OBJECTIVES: The authors assess the costs associated with treatment of dyspepsia with histamine2 antagonists versus without availability of over-the-counter (OTC). METHODS: A cost analysis was performed using a decision-analysis model. Patients with an initial episode of dyspepsia were studied. The model includes costs associated with consumption of OTC and prescription (Rx) medications for dyspepsia, physician visits and associated diagnostic tes…
Compliance with antihypertensive therapy among elderly Medicaid enrollees
OBJECTIVES: This study measured compliance and related demographic factors in a retrospective cohort of 4068 elderly outpatients newly starting antihypertensive therapy from 1982 through 1988. METHODS: Logistic regression modeling of data from the New Jersey Medicaid program was used. RESULTS: These patients filled antihypertensive prescriptions covering an average of only 179 days in the 365-day follow-up period (49%) Good compliance (> or = 80%…
Drug regulation and drug information--who should do what to whom
Drug regulation and drug information--who should do what to whom? J AvornCopyRight https://doi.org/10.2105/AJPH.85.1.18 Published Online: October 07, 2011
Treatment for glaucoma
OBJECTIVES. The purpose of this study was to determine the extent of nonadherence to treatment for glaucoma among elderly patients. METHODS. This was a retrospective cohort study of 2440 patients older than age 65 who were enrolled in the New Jersey Medicaid Program and who were newly initiated on a topical agent for the treatment of glaucoma. Two patient-specific measures of nonadherence were employed: (1) no filled prescription for any glaucoma…
Depressive symptoms in blood donors notified of HIV infection
OBJECTIVES. Understanding more about the psychological state of persons notified of human immunodeficiency virus (HIV) infection is critical for designing notification and counseling programs that will have the most positive effect. METHODS. The subjects were blood donors who had been notified of HIV infection by the New York Blood Center. A nurse elicited a medical history, performed a limited medical examination, and asked the subjects to compl…
Influence of Knowledge and Attitudes on the Quality of Physicians?? Transfusion Practice
Studies evaluating relationships between physician background characteristics (e.g. years of practice and medical training) and quality of care have found few consistent associations. Site of practice variables have been better predictors of quality than have characteristics of individual physicians. This study explores the relationship between physicians' knowledge and attitudes regarding the use of blood products, and the quality of their trans…
Improving Choice of Prescribed Antibiotics Through Concurrent Reminders in an Educational Order Form
Soumerai, Stephen B. ScD; Avorn, Jerry MD; Taylor, William C. MD; Wessels, Michael MD; Maher, Donna RN; Hawley, Sharon L. BA Author Information
Physician motivations for nonscientific drug prescribing
Compliance with antihypertensive therapy among elderly Medicaid enrollees
OBJECTIVES: This study measured compliance and related demographic factors in a retrospective cohort of 4068 elderly outpatients newly starting antihypertensive therapy from 1982 through 1988. METHODS: Logistic regression modeling of data from the New Jersey Medicaid program was used. RESULTS: These patients filled antihypertensive prescriptions covering an average of only 179 days in the 365-day follow-up period (49%) Good compliance (> or = 80%…
Treatment for glaucoma
OBJECTIVES. The purpose of this study was to determine the extent of nonadherence to treatment for glaucoma among elderly patients. METHODS. This was a retrospective cohort study of 2440 patients older than age 65 who were enrolled in the New Jersey Medicaid Program and who were newly initiated on a topical agent for the treatment of glaucoma. Two patient-specific measures of nonadherence were employed: (1) no filled prescription for any glaucoma…
Effect of government and commercial warnings on reducing prescription misuse
We analyzed trends in prescribing and overdose deaths related to propoxyphene (e.g., Darvon) before and after a 1978-80 informational campaign carried out by the US Food and Drug Administration and the drug's manufacturer through mailed warnings, face-to-face education of prescribers, press releases, and labeling changes. The goals included a reduction in propoxyphene use with alcohol or other CNS depressants, reduced prescribing of refills, and …
Depressive symptoms in blood donors notified of HIV infection
OBJECTIVES. Understanding more about the psychological state of persons notified of human immunodeficiency virus (HIV) infection is critical for designing notification and counseling programs that will have the most positive effect. METHODS. The subjects were blood donors who had been notified of HIV infection by the New York Blood Center. A nurse elicited a medical history, performed a limited medical examination, and asked the subjects to compl…
Sociodemographic and behavioral characteristics of HIV antibody-positive blood donors
This paper describes the sociodemographic and behavioral characteristics of 173 blood donors who were confirmed by Western blot tests to have antibodies to human immunodeficiency virus (HIV), the etiologic agent for acquired immunodeficiency syndrome (AIDS). Seropositive donors were predominantly young, unmarried, and male, and major risk factors could be identified for almost all donors. However, more than 20 per cent of the study participants w…
Drug regulation and drug information--who should do what to whom
Drug regulation and drug information--who should do what to whom? J AvornCopyRight https://doi.org/10.2105/AJPH.85.1.18 Published Online: October 07, 2011
Attitudes of the medical profession toward drug abuse
Attitudes of the medical profession toward drug abuse. J Lieff, J Avorn, H Caddell, H Anderson, P Gorlin, S Kennedy, J Goodwin, and L VerlendenCopyRight https://doi.org/10.2105/AJPH.63.12.1035 Published Online: October 07, 2011
Going to see the doctor
PpGerry Stimson and Barbara Webb, Going to See the Doctor
Ethics and Experts
Cheryl Noble discusses the emergence of applied ethics as a subdiscipline and expresses skepticism about the role of the philosopher as a technical "expert" on social problems. Peter Singer applauds the renewed interest of philosophers in social issues and points out the special advantages they may contribute to discussions of such issues. Jerry Avorn, a physician, sees a useful role for ethicists as teachers and resources for medical practitione…
Effect of government and commercial warnings on reducing prescription misuse
We analyzed trends in prescribing and overdose deaths related to propoxyphene (e.g., Darvon) before and after a 1978-80 informational campaign carried out by the US Food and Drug Administration and the drug's manufacturer through mailed warnings, face-to-face education of prescribers, press releases, and labeling changes. The goals included a reduction in propoxyphene use with alcohol or other CNS depressants, reduced prescribing of refills, and …
Predictors of Physician Prescribing Change in an Educational Experiment to Improve Medication Use
In analyzing a university-based program to educate physicians about proper medication use, we sought to measure whether physician background characteristics and the quality or number of educational exposures influenced the rate of relinquishment of inappropriate prescribing. A sample of 435 doctors was randomized to control and experimental groups; interventions consisted of printed educational materials and face-to-face visits by clinical pharma…
Sociodemographic and behavioral characteristics of HIV antibody-positive blood donors
This paper describes the sociodemographic and behavioral characteristics of 173 blood donors who were confirmed by Western blot tests to have antibodies to human immunodeficiency virus (HIV), the etiologic agent for acquired immunodeficiency syndrome (AIDS). Seropositive donors were predominantly young, unmarried, and male, and major risk factors could be identified for almost all donors. However, more than 20 per cent of the study participants w…
Physician motivations for nonscientific drug prescribing
Behavior changes after notification of HIV infection
BACKGROUND. To learn more about how people who did not volunteer for testing react to information about HIV infection, we assessed short-term behavior changes in HIV-positive blood donors. METHODS. Blood donors who were notified at the New York Blood Center that they were HIV positive were asked to participate in a study. A nurse elicited a medical history, performed a limited medical examination, and asked participants to complete a questionnair…
Treatment for glaucoma
OBJECTIVES. The purpose of this study was to determine the extent of nonadherence to treatment for glaucoma among elderly patients. METHODS. This was a retrospective cohort study of 2440 patients older than age 65 who were enrolled in the New Jersey Medicaid Program and who were newly initiated on a topical agent for the treatment of glaucoma. Two patient-specific measures of nonadherence were employed: (1) no filled prescription for any glaucoma…
Depressive symptoms in blood donors notified of HIV infection
OBJECTIVES. Understanding more about the psychological state of persons notified of human immunodeficiency virus (HIV) infection is critical for designing notification and counseling programs that will have the most positive effect. METHODS. The subjects were blood donors who had been notified of HIV infection by the New York Blood Center. A nurse elicited a medical history, performed a limited medical examination, and asked the subjects to compl…
Influence of Knowledge and Attitudes on the Quality of Physicians?? Transfusion Practice
Studies evaluating relationships between physician background characteristics (e.g. years of practice and medical training) and quality of care have found few consistent associations. Site of practice variables have been better predictors of quality than have characteristics of individual physicians. This study explores the relationship between physicians' knowledge and attitudes regarding the use of blood products, and the quality of their trans…
Improving Choice of Prescribed Antibiotics Through Concurrent Reminders in an Educational Order Form
Soumerai, Stephen B. ScD; Avorn, Jerry MD; Taylor, William C. MD; Wessels, Michael MD; Maher, Donna RN; Hawley, Sharon L. BA Author Information
Drug regulation and drug information--who should do what to whom
Drug regulation and drug information--who should do what to whom? J AvornCopyRight https://doi.org/10.2105/AJPH.85.1.18 Published Online: October 07, 2011
Compliance with antihypertensive therapy among elderly Medicaid enrollees
OBJECTIVES: This study measured compliance and related demographic factors in a retrospective cohort of 4068 elderly outpatients newly starting antihypertensive therapy from 1982 through 1988. METHODS: Logistic regression modeling of data from the New Jersey Medicaid program was used. RESULTS: These patients filled antihypertensive prescriptions covering an average of only 179 days in the 365-day follow-up period (49%) Good compliance (> or = 80%…
Policy Analysis of the Conversion of Histamine2 Antagonists to Over-the-Counter Use
OBJECTIVES: The authors assess the costs associated with treatment of dyspepsia with histamine2 antagonists versus without availability of over-the-counter (OTC). METHODS: A cost analysis was performed using a decision-analysis model. Patients with an initial episode of dyspepsia were studied. The model includes costs associated with consumption of OTC and prescription (Rx) medications for dyspepsia, physician visits and associated diagnostic tes…
Patient Noncompliance in the Managed Care Setting
OBJECTIVES: The authors identify demographic and clinical characteristics associated with noncompliance in patients beginning medical therapy for the treatment of glaucoma in a managed care setting. METHODS: The authors describe a retrospective cohort study in a group-model health maintenance organization in Massachusetts. Patients were members of the health maintenance organization who were newly initiated on topical drug therapy to treat open-a…
Trends in Knee Magnetic Resonance Imaging
OBJECTIVE: To assess trends in knee magnetic resonance imaging (MRI) use and accompanying management changes to determine whether indications for this test have changed over time. DATA SOURCES: Large administrative database containing health care information for 587,010 people living in 1 state who were enrolled in the Medicare or Medicaid programs. They all had used health services during 3 consecutive years between 1991 to 1995. METHODS: We per…
Variable Selection for Propensity Score Models
Despite the growing popularity of propensity score (PS) methods in epidemiology, relatively little has been written in the epidemiologic literature about the problem of variable selection for PS models. The authors present the results of two simulation studies designed to help epidemiologists gain insight into the variable selection problem in a PS analysis. The simulation studies illustrate how the choice of variables that are included in a PS m…
Educating Trainees about the Cost of Medications
Medical students and residents should be taught about the cost of prescription medication, how these costs affect patient compliance, and how they can help alleviate the financial burden of prescription drugs. Virtual Mentor is a monthly bioethics journal published by the American Medical Association
Prior Authorization Policies for Selective Cyclooxygenase-2 Inhibitors in Medicaid
BACKGROUND: Many state Medicaid programs use prior authorization programs to limit spending on cyclooxygenase-2 selective nonsteroidal anti-inflammatory drugs (coxibs). However, the evidence base for the prior authorization criteria has not been examined previously. METHODS: We determined whether prior authorization was required for coxibs in state Medicaid programs and collected data on what precise criteria needed to be met for a coxib prescrip…
Design of Cluster-Randomized Trials of Quality Improvement Interventions Aimed at Medical Care Providers
BACKGROUND: Randomized trials aimed at improving the quality of medical care often randomize the provider. Such trials are frequently embedded in health care systems with available automated records, which can be used to enhance the design of the trial. METHODS: We consider how available information from automated records can address each of the following concerns in the design of a trial: whether to randomize individual providers or practices; c…
The Medical License Number Accurately Identifies the Prescribing Physician in a Large Pharmacy Claims Database
BACKGROUND: Medical license numbers that identify physicians in pharmacy claims data are used increasingly for both research and quality improvement efforts; however, little is known about how well this information identifies the physician who wrote the prescription. We studied the accuracy of the medical license number in data from a state-run drug benefit plan by assessing its consistency with 2 external sources of data. METHODS: We studied a c…
Increasing Levels of Restriction in Pharmacoepidemiologic Database Studies of Elderly and Comparison With Randomized Trial Results
BACKGROUND: The goal of restricting study populations is to make patients more homogeneous regarding potential confounding factors and treatment effects and thereby achieve less biased effect estimates. OBJECTIVES: This article describes increasing levels of restrictions for use in pharmacoepidemiology and examines to what extent they change rate ratio estimates and reduce bias in a study of statin treatment and 1-year mortality. METHODS: : The s…
Adjustments for Unmeasured Confounders in Pharmacoepidemiologic Database Studies Using External Information
BACKGROUND: Nonexperimental studies of drug effects in large automated databases can provide timely assessment of real-life drug use, but are prone to confounding by variables that are not contained in these databases and thus cannot be controlled. OBJECTIVES: To describe how information on additional confounders from validation studies can help address the problem of unmeasured confounding in the main study. RESEARCH DESIGN: Review types of vali…
Medicine (34 obras) · Medical prescription (16 obras) · Family medicine (15 obras) · Health care (11 obras) · Internal Medicine (11 obras) · Internal Medicine (11 obras) · Nursing (11 obras) · Medicaid (9 obras) · Medication Adherence and Compliance (9 obras) · Pharmaceutical industry and healthcare (8 obras)