Paper Examines Medicaid Patients and Healthcare

A paper co-written by Dr. Wayne Macfadden, former attending psychiatrist with the Princeton Healthcare Medical Center in Princeton, New Jersey, explores the costs patients with bipolar disorder incur to the Medicaid program. For this particular study, researchers looked at individuals with bipolar disorder type one, some of which required regular psychiatric interventions. Dr. Wayne Macfadden and his peers analyzed material from a Medicaid database to pinpoint patients who had more than two clinically significant events , such as hospitalizations or emergency room visits, linked to bipolar disorder in a year’s time. Such patients were classified as having received frequent psychiatric interventions (FPI).

According to the study, which was published in the Journal of Medical Economics, of the roughly 5,525 patients examined, 53 percent experienced FPIs. These patients were generally younger than those who did not require FPIs. Further, they incurred a higher cost to the Medicaid system than patients not requiring FPI.

This study appeared under the title “Characteristics, Healthcare Utilization and Costs of Bipolar Disorder Type I Patients with and Without Frequent Psychiatric Intervention in a Medicaid Population.”

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Co-authored articles in peer reviewed journals: Ophthalmology

From 2015 to 2018, I was a Global Medical Affairs Director for Novartis in their Ophthalmology division with Ranibizumab. Below are a few of the publications that resulted from my work there:

https://www.ncbi.nlm.nih.gov/pubmed/31047547

Systemic Safety in Ranibizumab-Treated Patients with Neovascular Age-Related Macular Degeneration: A Patient-Level Pooled Analysis

https://www.ncbi.nlm.nih.gov/pubmed/28961671

Long-Term Outcomes of Ranibizumab Treatment of Myopic Choroidal Neovascularization In East-Asian Patients From the Radiance Study

https://www.ncbi.nlm.nih.gov/pubmed/28893454

Treat-and-Extend versus Monthly Regimen in Neovascular Age-Related Macular Degeneration: Results with Ranibizumab from the TREND Study

Treating Acute Pain in Patients Prescribed Buprenorphine Products for Opioid Use Disorders

Interesting, as pain control is a often a challenge for physicians treating patients taking buprenorphine

Janaburson's Blog

Many physicians still get confused about how to treat acute pain in patients who are prescribed buprenorphine products for opioid use disorder.

While buprenorphine products (whether Suboxone, Subutex, Zubsolv, Bunavail, or the generic forms of these) are partial opioids, when they are prescribed long-term for treatment of opioid use disorder, they don’t work very well for moderate or severe pain. These patients usually also need treatment with short-acting opioids.

Buprenorphine has a high affinity for the opioid receptors in the brain, which means this medication sticks to those receptors like glue. Other opioids, with lower affinities, have more difficult time exerting their effects in the central nervous system. This high affinity for receptors is one feature of buprenorphine that makes it work so well for patients with opioid use disorder, but we’ve worried that it also can complicate the treatment of acute pain in those patients.

If the pain is…

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How Does Risperidone Work and What Does it Treat? By Wayne Macfadden MD

Wayne Macfadden's WordPress Blog

An antipsychotic medication, risperidone may regulate the balance of brain neurotransmitters. Scientists posit that abnormal communication among nerve cells in the brain causes most psychotic illnesses. Therefore, by altering communication through neurotransmitters, risperidone alters the psychotic state. This medication helps patients to think clearly and to improve their functioning in daily life.

Risperidone is widely used to treat schizophrenia, a mental illness characterized by unusual or disturbed thinking, inappropriate or strong emotions, and loss of interest in life. Psychiatrists also prescribe risperidone to patients with bipolar disorder who experience episodes of mania, which is a display of abnormal or frenzied excitement, or for mixed episodes, where mania and depression occur together. Furthermore, psychiatrists use risperidone to treat persons with autism who undergo sudden mood changes, display aggression, or are at risk of self-injury. While risperidone controls the symptoms of mental illness, it does not cure these mental conditions.

About the…

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Expert in Bipolar Disorders

Wayne Macfadden's WordPress Blog

Dr. Wayne Macfadden has practiced psychiatry for more than 20 years and takes a particular interest in bipolar disorder, a topic on which he has published extensively. Dr. Wayne Macfadden has authored several articles on the efficacy of the drug quetiapine as a monotherapy for bipolar disorder.

Bipolar disorder is a highly recurrent and sometimes chronic mood disorder that presents as an alternation between periods of deep depression and periods of mania. It normally manifests in two forms: bipolar I, in which symptoms of depression exceed those of mania by a ration of about 3:1; and bipolar II, in which patients spend even more time in the depressive pole than the manic pole. Some bipolar patients experience rapid cycling or mood shifts between mania and depression that occur very quickly, usually within the course of a few hours. The mood swings associated with bipolar disorder can play havoc with a…

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