Patient Medication Status

LA2K Patients: Medication Status

Data are based off of the Medication Status form as coded in the HTAC databse (downloaded 5/31/12); the following was conducted by EC, KK, AB in consultation with RMB.

N = 257 patients with a completed Medication Status form (83 SZ, 89 BP, 85 ADHD), but many of these are not valid/completers. The following data are based on the N = 153 patients whose Status = Complete and with complete Medication Status Forms (58 SZ, 49 BP, 46 ADHD).

I. We categorized the specific drugs entered into 11 main categories:

   1. Antipsychotic 

   2. Psychostimulant 

   3. Antidepressant 

   4. Anticonvulsant-Mood Stabilizer 

   5. Sedative-Hypnotic 

   6. Analgesic 

   7. Hormone 

   8. Anxiolytic 

   9. Antiparkinsonian 

   10. Anticholinergic 

   11. Other (includes: Cannabis, SNRI, Antihypertensive, Antihistamine, Anoretic, Xyrem, Modafanil) 

II. We determined a fixed washout time window for each specific drug, then took the max within each category, and applied that fixed washout time window for each drug within that category to determine Current Use.
A. Following consultation with Cesi, we used Pavuluri, M. N. & Janicak, P. G. Handbook of Psychopharmocology: A Life-Span Approach (2nd Edition). Philadelphia: Lippincott Williams and Wilkins (2009), to determine 10x the Half-Life of each specific drug.
B. The maximum time window was selected from each category.
C. This conservative washout time window was then applied for each specific drug within each category.
D. We then re-coded Current Use, as follows:

       1. Current Use = 1 (no stop date entered, and use = 1) 

       2. Current Use = 1 (stop date entered that falls within the washout time window) 

       3. Current Use = 0 (stop date entered that falls outside the washout time window) 

III. We then coded whether each subject had Current Use for each of the 11 categories. These new columns will be used to determine the final numbers of subjects receiving each category of medication, and to sort into lists of subjects for Step IV.

IV. Analysis Strategies to address medication status:

A. For primary analyses that include patients, first run the main analyses, then repeat each analysis, removing subjects with Current Use for each drug category (removing one category at a time) in order to establish whether medication use of each category is driving/obscuring the group effect. A limitation of this approach is that the majority of a given group may be users of a drug category (e.g., SZ patients taking Antipsychotics), which greatly reduced power to test for anything.

B. After conducting primary analyses, conduct follow-up analyses within each patient group alone, comparing those On vs. Off medication, and only consider medications for which the majority of that patient group are current users (e.g., compare ADHD On vs. Off Psychostimulants, because at least 30% of the sample is taking them, but ignore Anticonvulsant-Mood Stabilizers because less than 10% of the sample is taking them).

V. LA2K Patients by Medication Table:

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