Dataset Information

Space-Time Cluster Analysis to Detect Innovative Clinical Practices: A Case Study of Aripiprazole in the Department of Veterans Affairs.

ABSTRACT:

Objective

To identify space-time clusters of changes in prescribing aripiprazole for bipolar disorder among providers in the VA.

Data sources

VA administrative data from 2002 to 2010 were used to identify prescriptions of aripiprazole for bipolar disorder. Prescriber characteristics were obtained using the Personnel and Accounting Integrated Database.

Study design

We conducted a retrospective space-time cluster analysis using the space-time permutation statistic.

Data extraction methods

All VA service users with a diagnosis of bipolar disorder were included in the patient population. Individuals with any schizophrenia spectrum diagnoses were excluded. We also identified all clinicians who wrote a prescription for any bipolar disorder medication.

Principal findings

The study population included 32,630 prescribers. Of these, 8,643 wrote qualifying prescriptions. We identified three clusters of aripiprazole prescribing centered in Massachusetts, Ohio, and the Pacific Northwest. Clusters were associated with prescribing by VA-employed (vs. contracted) prescribers. Nurses with prescribing privileges were more likely to make a prescription for aripiprazole in cluster locations compared with psychiatrists. Primary care physicians were less likely.

Conclusions

Early prescribing of aripiprazole for bipolar disorder clustered geographically and was associated with prescriber subgroups. These methods support prospective surveillance of practice changes and identification of associated health system characteristics.

SUBMITTER: Penfold RB

PROVIDER: S-EPMC5785329 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Space-Time Cluster Analysis to Detect Innovative Clinical Practices: A Case Study of Aripiprazole in the Department of Veterans Affairs.

Penfold Robert B RB Burgess James F JF Lee Austin F AF Li Mingfei M Miller Christopher J CJ Nealon Seibert Marjorie M Semla Todd P TP Mohr David C DC Kazis Lewis E LE Bauer Mark S MS

Health services research 20161222 1

<h4>Objective</h4>To identify space-time clusters of changes in prescribing aripiprazole for bipolar disorder among providers in the VA.<h4>Data sources</h4>VA administrative data from 2002 to 2010 were used to identify prescriptions of aripiprazole for bipolar disorder. Prescriber characteristics were obtained using the Personnel and Accounting Integrated Database.<h4>Study design</h4>We conducted a retrospective space-time cluster analysis using the space-time permutation statistic.<h4>Data ex ...[more]

PMID: 28004385

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Dataset Information

Space-Time Cluster Analysis to Detect Innovative Clinical Practices: A Case Study of Aripiprazole in the Department of Veterans Affairs.

Objective

Data sources

Study design

Data extraction methods

Principal findings

Conclusions

Publications

Space-Time Cluster Analysis to Detect Innovative Clinical Practices: A Case Study of Aripiprazole in the Department of Veterans Affairs.

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