Procedure costs and outcomes associated with pharmacologic management of peripheral arterial disease in the department of defense

• Published in: Clinical therapeutics 1999-08, Vol.21 (8), p.1358-1369
• Main Authors: Zachry, Woodie M., Wilson, James P., Lawson, Kenneth A., Koeller, Jim M.
• Format: Article
• Language: English
• Subjects: Adult; Arteriosclerosis - drug therapy; Arteriosclerosis - economics; aspirin; Biological and medical sciences; Cardiovascular system; cost of procedures; Data Collection; Delivery of Health Care - economics; Delivery of Health Care - utilization; dipyridamole; Humans; Medical sciences; Middle Aged; pentoxifylline; peripheral arterial disease; peripheral vascular disease; Peripheral Vascular Diseases - drug therapy; Peripheral Vascular Diseases - economics; Pharmacology, Clinical - economics; Pharmacology. Drug treatments; Retrospective Studies; Treatment Outcome; United States; Vasodilator agents. Cerebral vasodilators
• ISSN: 0149-2918; 1879-114X
• DOI: 10.1016/S0149-2918(99)80036-8

This study was undertaken to determine if differences existed between pharmacologic treatments of peripheral arterial disease (PAD) with respect to PAD-related costs and health care outcomes in the United States Department of Defense health care system. We performed a retrospective review of hospital and prescription data to explore the effects of at least 90 days of aspirin, pentoxifylline, papaverine, or dipyridamole on 4 PAD-related outcomes: number of PAD-related invasive procedures (INV), number of PAD-related examination procedures (EXM), number of PAD-related hospitalization days (HDAYS), and cost of PAD-related procedures (COST) during 5 years. A covariate representing the number of PAD-related hospitalizations before the study period was used to attempt to control for severity of disease state. General linear models were used in the analyses. A statistically significant difference was seen between treatment groups for a linear combination of INV, EXM, HDAYS, and COST when controlling for past PAD-related hospitalizations ( P < 0.014). A statistically significant relationship existed between treatment groups and INV ( P < 0.041). The pentoxifylline treatment group had a statistically significant higher covariate-adjusted mean INV compared with the aspirin treatment group ( P < 0.043). Also, PAD-related past hospitalizations were significantly related to EXM ( P < 0.006). Our results appear to support the use of aspirin as a preventive treatment in PAD compared with pentoxifylline or dipyridamole.