AdvancePCS

About: AdvancePCS is a based out in . It is known for research contribution in the topics: Population & Economic cost. The organization has 29 authors who have published 43 publications receiving 6208 citations. The organization is also known as: AdvancePCS Inc..

Lost Productive Time and Cost Due to Common Pain Conditions in the US Workforce

Abstract: ContextCommon pain conditions appear to have an adverse effect on work, but no comprehensive estimates exist on the amount of productive time lost in the US workforce due to pain.ObjectiveTo measure lost productive time (absence and reduced performance due to common pain conditions) during a 2-week period.Design and SettingCross-sectional study using survey data from the American Productivity Audit (a telephone survey that uses the Work and Health Interview) of working adults between August 1, 2001, and July 30, 2002.ParticipantsRandom sample of 28 902 working adults in the United States.Main Outcome MeasuresLost productive time due to common pain conditions (arthritis, back, headache, and other musculoskeletal) expressed in hours per worker per week and calculated in US dollars.ResultsThirteen percent of the total workforce experienced a loss in productive time during a 2-week period due to a common pain condition. Headache was the most common (5.4%) pain condition resulting in lost productive time. It was followed by back pain (3.2%), arthritis pain (2.0%), and other musculoskeletal pain (2.0%). Workers who experienced lost productive time from a pain condition lost a mean (SE) of 4.6 (0.09) h/wk. Workers who had a headache had a mean (SE) loss in productive time of 3.5 (0.1) h/wk. Workers who reported arthritis or back pain had mean (SE) lost productive times of 5.2 (0.25) h/wk. Other common pain conditions resulted in a mean (SE) loss in productive time of 5.5 (0.22) h/wk. Lost productive time from common pain conditions among active workers costs an estimated $61.2 billion per year. The majority (76.6%) of the lost productive time was explained by reduced performance while at work and not work absence.ConclusionsPain is an inordinately common and disabling condition in the US workforce. Most of the pain-related lost productive time occurs while employees are at work and is in the form of reduced performance.

Cost of lost productive work time among US workers with depression.

Abstract: ContextEvidence consistently indicates that depression has adversely affected work productivity. Estimates of the cost impact in lost labor time in the US workforce, however, are scarce and dated.ObjectiveTo estimate the impact of depression on labor costs (ie, work absence and reduced performance while at work) in the US workforce.Design, Setting, and ParticipantsAll employed individuals who participated in the American Productivity Audit (conducted August 1, 2001–July 31, 2002) between May 20 and July 11, 2002, were eligible for the Depressive Disorders Study. Those who responded affirmatively to 2 depression-screening questions (n = 692), as well as a 1:4 stratified random sample of those responding in the negative (n = 435), were recruited for and completed a supplemental interview using the Primary Care Evaluation of Mental Disorders Mood Module for depression, the Somatic Symptom Inventory, and a medical and treatment history for depression. Excess lost productive time (LPT) costs from depression were derived as the difference in LPT among individuals with depression minus the expected LPT in the absence of depression projected to the US workforce.Main Outcome MeasureEstimated LPT and associated labor costs (work absence and reduced performance while at work) due to depression.ResultsWorkers with depression reported significantly more total health-related LPT than those without depression (mean, 5.6 h/wk vs an expected 1.5 h/wk, respectively). Eighty-one percent of the LPT costs are explained by reduced performance while at work. Major depression accounts for 48% of the LPT among those with depression, again with a majority of the cost explained by reduced performance while at work. Self-reported use of antidepressants in the previous 12 months among those with depression was low (<30%) and the mean reported treatment effectiveness was only moderate. Extrapolation of these survey results and self-reported annual incomes to the population of US workers suggests that US workers with depression employed in the previous week cost employers an estimated $44 billion per year in LPT, an excess of $31 billion per year compared with peers without depression. This estimate does not include labor costs associated with short- and long-term disability.ConclusionsA majority of the LPT costs that employers face from employee depression is invisible and explained by reduced performance while at work. Use of treatments for depression appears to be relatively low. The combined LPT burden among those with depression and the low level of treatment suggests that there may be cost-effective opportunities for improving depression-related outcomes in the US workforce.

Factors associated with the onset and remission of chronic daily headache in a population-based study

Abstract: The etiology and prognosis of chronic daily headache (CDH) are not well understood. The aim of this study is to describe factors that predict CDH onset or remission in an adult population. Potential cases (180+ headaches per year, n =1134) and controls (two to 104 headaches per year, n =798) were interviewed two times over an average 11 months of follow-up. Factors associated with CDH prevalence at baseline were evaluated. The incidence of CDH and risk factors for onset were assessed in controls whose headache frequency increased to 180+ per year at follow-up. Prognostic factors were assessed in CDH cases whose headache frequency fell at follow-up. CDH was more common in women, in whites, and those of less education. CDH cases were more likely to be previously married (divorced, widowed, separated), obese, and report a physician diagnosis of diabetes or arthritis. At follow-up, 3% of the controls reported 180 or more headaches per year. Obesity and baseline headache frequency were significantly associated with new onset CDH. In CDH cases, the projected 1-year remission rate to less than one headache per week was 14% and to less than 180 headaches per year was 57%. A better prognosis was associated with higher education, non-white race, being married, and with diagnosed diabetes. Individuals with less than a high-school education, whites, and those who were previously married had a higher risk of CDH at baseline and reduced likelihood of remission at follow-up. New onset CDH was associated with baseline headache frequency and obesity.

Lost productive work time costs from health conditions in the United States: results from the American Productivity Audit.

Abstract: The American Productivity Audit (APA) is a telephone survey of a random sample of 28,902 U.S. workers designed to quantify the impact of health conditions on work. Lost productive time (LPT) was measured for personal and family health reasons and expressed in hours and dollars. Health-related LPT cost employers 225.8 billion US dollars/year (1685 US dollars/employee per year); 71% is explained by reduced performance at work. Personal health LPT was 30% higher in females and twice as high in smokers (> or =1 pack/day) versus nonsmokers. Workers in high-demand, low-control jobs had the lowest average LPT/week versus the highest LPT for those in low-demand, high-control jobs. Family health-related work absence accounted for 6% of all health-related LPT. Health-related LPT costs are substantial but largely invisible to employers. Costs vary significantly by worker characteristics, suggesting that intervention needs vary by specific subgroups.

Petasites hybridus root (butterbur) is an effective preventive treatment for migraine.

Abstract: Objective: To evaluate the clinical efficacy of a standardized special root extract from the plant Petasites hybridus as a preventive therapy for migraine. Methods: This is a three-arm, parallel-group, randomized trial comparing Petasites extract 75 mg bid, Petasites extract 50 mg bid, or placebo bid in 245 patients with migraine. Eligible patients met International Headache Society criteria for migraine, were ages 18 to 65, and had at least two to six attacks per month over the preceding 3 months. The main outcome measure was the decrease in migraine attack frequency per month calculated as percentage change from baseline over a 4-month treatment period. Results: Over 4 months of treatment, in the per-protocol analysis, migraine attack frequency was reduced by 48% for Petasites extract 75 mg bid ( p = 0.0012 vs placebo), 36% for Petasites extract 50 mg bid ( p = 0.127 vs placebo), and 26% for the placebo group. The proportion of patients with a ≥50% reduction in attack frequency after 4 months was 68% for patients in the Petasites extract 75-mg arm and 49% for the placebo arm ( p Petasites 75 mg at 1, 2, and 3 months based on this endpoint. The most frequently reported adverse reactions considered possibly related to treatment were mild gastrointestinal events, predominantly burping. Conclusions: Petasites extract 75 mg bid is more effective than placebo and is well tolerated as a preventive therapy for migraine. Petasites 50 mg PO bid was not significantly more effective than placebo on the primary study endpoints.