Supplementary material: Risk of long-term care admissions among Medicare beneficiaries treated with pimavanserin or quetiapine for Parkinson’s disease psychosis in USA: a retrospective administrative claims database analysis

These are peer-reviewed supplementary tables and figures for the article 'Risk of long-term care admissions among Medicare beneficiaries treated with pimavanserin or quetiapine for Parkinson’s disease psychosis in USA: a retrospective administrative claims database analysis' published in the Journal of Comparative Effectiveness Research.Supplementary Table 1: Diagnostic Code List Used in Patient SelectionSupplementary Table 2: PIM vs. Other-AAPs: Rates and Time to first LTC admission in 1 year of follow-upSupplementary Table 3: Baseline Patient Demographics among Pre-matched and Post-matched Pimavanserin and Other-Atypical AntipsychoticsSupplementary Table 4: Baseline Patient Comorbidities among Pre-matched and Post-matched Pimavanserin and Other-Atypical AntipsychoticsSupplementary Table 5: Odds Ratios and 95% Confidence Interval in Matched Cohort, by setting for PIM vs. Other-AAPs*Supplementary Table 6: STROBE Statement—Checklist of Items that Should be Included in Reports of Observational StudiesSupplementary Figure 1: The density of propensity scores before and after matching for PIM vs. other-AAPsSupplementary Figure 2: The boxplot of propensity scores before and after matching PIM vs. AAPSupplementary Figure 3: The density of propensity scores before and after matching for PIM vs. QUESupplementary Figure 4: The boxplot of propensity scores before and after matching for PIM vs. QUEAim: Risk of long-term care (LTC) admission (LTCA) associated with atypical antipsychotic (AAP) use among patients with Parkinson’s disease psychosis (PDP) is a major concern. However, no comparative studies have examined the differences in risk of LTC admissions between pimavanserin (PIM), the only FDAapproved AAP for PDP, and other off-label AAPs including quetiapine (QUE). Objective: To examine all cause LTCA rates and risk among PDP patients treated with AAPs such as QUE or PIM. Methods: Analysis of Parts A, B and D claims (100% Medicare sample; 2013–2019) of Medicare beneficiaries with PDP that initiate ≥12-month continuous PIM or QUE monotherapy from 1 January 2014 to 31 December 2018 (i.e.,index date) without any AAP use in the 12-month pre-index period was conducted. Outcome assessments among 1:1 propensity score-matched (31 variables – age, sex, race, region and 27 Elixhauser comorbidities) beneficiaries on PIM versus QUE included risk of all-cause skilled nursing facility stays (SNF-stays), LTCstays, and overall LTCA (i.e., SNF-stays or LTC-stays). All-cause LTCA rates and LTCA risk were compared using logistic regression and cox proportional hazards models, respectively, controlling for demographics, comorbidities and co-existing-dementia or insomnia. Results: Of the matched sample (n = 842 for each group) from total sample (n = 9652), overall all-cause LTCA and SNF-stay rates were 23.2 and 20.2% for PIM versus 33.8 and 31.4% for QUE, respectively (p < 0.05, for each). Hazard ratio (95% CI) for risk of SNF-stay and overall LTCA was 0.78 (0.61, 0.98) and 0.80 (0.66, 0.97), respectively, for PIM versus QUE beneficiaries (p < 0.05, for each). Conclusion: The 20% lower risk of LTCA (i.e., greater delay) with PIM versus QUE in this analysis may suggest that PIM should be started early for the treatment of PDP.

本数据集收录了发表于《比较疗效研究杂志》的论文《在美国使用哌泊噻嗪或喹硫平治疗帕金森病精神症状的医疗保险受益者的长期护理入院风险：一项回顾性行政索赔数据库分析》的同行评审补充表格和图表。补充表格1：用于患者选择的诊断代码列表；补充表格2：PIM与其它非典型抗精神病药（AAP）在1年随访期间首次长期护理入院（LTC）发生率和时间的比较；补充表格3：PIM与其它非典型抗精神病药在匹配前后的基线患者人口统计学特征；补充表格4：PIM与其它非典型抗精神病药在匹配前后的基线患者合并症；补充表格5：匹配队列中PIM与其它AAP的相对风险比（OR）和95%置信区间，按设置分类；补充表格6：STROBE声明——观察性研究报告应包含的项目清单；补充图表1：PIM与其它非典型抗精神病药匹配前后倾向得分密度；补充图表2：PIM与AAP匹配前后倾向得分的箱形图；补充图表3：PIM与喹硫平匹配前后倾向得分密度；补充图表4：PIM与喹硫平匹配前后倾向得分的箱形图。研究目的：探讨使用喹硫平或哌泊噻嗪等非典型抗精神病药治疗帕金森病精神症状（PDP）患者的帕金森病精神症状（PDP）患者全因长期护理入院（LTCA）风险。研究目标：考察使用AAP如喹硫平或哌泊噻嗪治疗PDP患者的全因LTCA发生率和风险。研究方法：对2014年1月1日至2018年12月31日期间开始接受≥12个月连续PIM或喹硫平单药治疗且在索引日期前12个月内未使用任何AAP的帕金森病精神症状（PDP）的医疗保险受益者的A部分、B部分和D部分的索赔记录（100%医疗保险样本；2013-2019年）进行了分析。在PIM与喹硫平的1:1倾向得分匹配（31个变量 - 年龄、性别、种族、地区和27个Elixhauser合并症）受益者中，对全因专业护理设施住院（SNF住院）、LTC住院和总体LTCA（即SNF住院或LTC住院）的风险进行了评估。使用逻辑回归和Cox比例风险模型比较了全因LTCA发生率和LTCA风险，同时控制了人口统计学、合并症和共存痴呆或失眠。研究结果：在总样本（n = 9652）中，匹配样本（每组n = 842）的全因LTCA和SNF住院率分别为PIM的23.2%和20.2%，而喹硫平分别为33.8%和31.4%（p < 0.05，每组）。PIM受益者与喹硫平受益者的SNF住院和总体LTCA的风险比（95% CI）分别为0.78（0.61，0.98）和0.80（0.66，0.97）（p < 0.05，每组）。研究结论：本分析中，与喹硫平相比，PIM的LTCA风险降低20%（即延迟更久）可能表明，PIM应尽早开始用于PDP的治疗。