Abstract:
OBJECTIVE:We evaluated the association of medication refill adherence with demographic and prescription characteristics to determine whether such factors could guide intervention strategies in an indigent rural population. METHODS:The study was conducted at a University-based internal medicine practice serving an indigent rural population. Refill data for diabetes, hypertension, and hypercholesterolemia drugs from a closed pharmacy system were used to calculate mean adherence (for all drugs taken by each patient) and minimum adherence (that of the least adhered to drug) for 1984 patients during a 9-month period. RESULTS:Mean refill adherence was <80% for 33% of the population and minimum refill adherence was <80% for 55% of the patients. Increasing age, race (white), and prescription length were associated with higher mean and minimum adherence, independent of income, prescription copay, and insurance status. Number of drugs taken had a positive mean but negative minimum adherence association. Gender, number of primary care visits, and dosage schedule were not independently associated with adherence. The model explained 6.8% of the variance in mean adherence. CONCLUSIONS:In a rural indigent population, medication refill adherence was associated with race, age, and prescription length, though these factors explained only a small amount of adherence variability. Although ingestion adherence is the goal, refill adherence is a necessary condition for ingestion adherence. To enhance adherence, physicians need better predictors to target their efforts to patients most in need of attention. Prescription claims data could serve this purpose.
journal_name
Med Carejournal_title
Medical careauthors
Schectman JM,Bovbjerg VE,Voss JDdoi
10.1097/00005650-200212000-00016keywords:
subject
Has Abstractpub_date
2002-12-01 00:00:00pages
1294-300issue
12eissn
0025-7079issn
1537-1948journal_volume
40pub_type
杂志文章相关文献
MEDICAL CARE文献大全abstract::An expository account of multiple time series analysis is presented. Modeling several related time series together makes it possible to ascertain dynamic leading, lagging, and feedback relationships among the series; to produce more efficient forecasts and, in some situations; to develop control schemes. Procedures fo...
journal_title:Medical care
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:Estimating population-level obesity rates is important for informing policy and targeting treatment. The current gold standard for obesity measurement in the United States-the National Health and Nutrition Examination Survey (NHANES)-samples <0.1% of the population and does not target state-level or health s...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000693
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:The practice of ordering "Do-Not-Resuscitate" (DNR) varies across hospitals. No research has explored how the DNR variation would affect cross-institutional performance reporting when DNR status is used as a risk adjustor. OBJECTIVE:We sought to assess the impact of DNR variation on performance reporting. ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000167106.09265.4e
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:The quality of care for Medicare beneficiaries with diabetes remains suboptimal. The contributing factors at the physician level are not well characterized, especially the relationship of patient volume and physician performance. OBJECTIVE:We sought to determine associations between the number of Medicare d...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000233685.22497.cf
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Adherence to medication treatment plans is important for chronic disease (CD) management. Cost-related nonadherence (CRN) puts patients at risk for complications. Native Hawaiians and Pacific Islanders (NHPI) suffer from high rates of CD and socioeconomic disparities that could increase CRN behaviors. OBJEC...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000887
更新日期:2018-04-01 00:00:00
abstract::This study examines evidence of market segmentation on the basis of patients' insurance status, demographic characteristics, and medical condition in selected local markets in California in the years 1983 and 1989. Substantial differences exist in the probability patients may be admitted to particular hospitals based ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199301000-00004
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Among older women with early-stage breast cancer, patients with a short life expectancy (LE) are much less likely to benefit from adjuvant radiation therapy (RT). Little is known about the impact of physicians and regional factors on the use of RT across LE groups. OBJECTIVE:To determine the relative contri...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31827631b0
更新日期:2013-04-01 00:00:00
abstract::The authors provide brief information about the Department of Veterans Affairs (VA) and the Veterans Health Administration, to establish an understanding of this large, multifaceted organization. They then offer an overview of the VA's Office of Research and Development, with particular emphasis on recent and ongoing ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.MLR.0000023950.96307.BD
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to assess the impact of removing prior-authorization restrictions on the use of thiazolidinediones (TZDs) and outcomes. METHODS:In a controlled interrupted time-series analysis, whereby new users of antidiabetic agents over 65 years of age in adjacent Canadian provinces with differe...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000006
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVES:Family members and other "carepartners" often play an important role in the care and support of patients during and after hospitalization, yet little is known about how they assess their hospital experience or the factors that may influence their perceptions. METHODS:A nationwide telephone survey of 1,800 r...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199901000-00006
更新日期:1999-01-01 00:00:00
abstract:INTRODUCTION:Growing adoption of electronic health records and increased emphasis on the reuse and integration of clinical care and administration data require a robust informatics infrastructure to inform health care effectiveness in real-world settings. The Scalable Architecture for Federated Translational Inquiries ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e318259bff4
更新日期:2012-07-01 00:00:00
abstract::A retention study was implemented in Marshfield, Massachusetts in May 1974 in order to ascertain if cardiopulmonary resuscitation (CPR) skills could be retained by secondary school students who had 15 months previously received training in mouth to mouth resuscitation and cardiac compression. The retention study also ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-197602000-00008
更新日期:1976-02-01 00:00:00
abstract::Physician integration strategies are attempts to bring physicians into hospital administration by giving them a role on the hospital board, employing them in administrative or clinical capacities, or expanding the administration issues dealt with by medical staff committees. This study used a production function model...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199007000-00005
更新日期:1990-07-01 00:00:00
abstract::Seven general surgeons in a prepaid group practice previously shown to have a mean operative work load of 9.2 hernia equivalents (HE) per week were found to have a standardized mean daytime working week of 56.2 hours, exclusive of evening activities of which 50.7 hours were devoted to professional activities. The surg...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-197610000-00003
更新日期:1976-10-01 00:00:00
abstract::In this article, we compared hospital efficiency using a multiple input-output approach in two ways: one way used a straightforward count of inpatient days and outpatient services as outputs; and the second used a case mix-adjusted count of inpatient services and outpatient care as outputs. Our results show that there...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199306000-00006
更新日期:1993-06-01 00:00:00
abstract:OBJECTIVES:To examine the prevalence of obesity and its relationship with pressure ulcers among nursing home (NH) populations, and whether such relationship varies with certified nursing assistant (CNA) level in NHs. DATA AND STUDY POPULATION: The 1999-2009 nationwide Minimum Data Sets were linked with Online Survey of...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3182881cb0
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:A need exists for adapting existing perioperative risk stratification methods such as the Charlson Comorbidity Index (CCI) for application with hospital administrative data in noncardiac surgery populations. OBJECTIVE:Develop and validate outcome-specific CCIs for predicting inpatient mortality, and cardiac...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000592
更新日期:2016-12-01 00:00:00
abstract::The desired form and style of written drug information for patients were assessed in a national survey of oral contraceptive (OC) users. These women were queried about two forms of OC information: a short insert included with dispensed drugs and a longer brochure delivered by the physician upon patient request. Longer...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-197812000-00008
更新日期:1978-12-01 00:00:00
abstract:BACKGROUND:The Program of All-Inclusive Care for the Elderly (PACE) is an acute/long-term managed care plan designed to care for the most frail and vulnerable Medicare beneficiaries. To our knowledge, this is a first study to examine patterns and predictors of disenrollment from PACE. OBJECTIVE:PACE, with its comprehe...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000188920.19129.89
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Latinos make up the largest group of minority children in the United States. Despite great diversity among Latino children, studies have traditionally treated them as a monolithic group. Few studies have examined patterns and determinants of access to and use of health care for different subgroups of Latino ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e318190d9e4
更新日期:2009-06-01 00:00:00
abstract::Earlier efforts of the Commission on Professional and Hospital Activities (CPHA) to develop a patient care data system for long-term care facilities were discontinued for lack of user interest and shortage of funds; however, the facilities were encouraged to participate in the hospital data system (PAS) and to use opt...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-197605001-00033
更新日期:1976-05-01 00:00:00
abstract:BACKGROUND:Without advanced preparation of legal documents, state law determines who may serve as a surrogate decision maker for patients in hospitals. OBJECTIVES:To examine the relationship characteristics associated with traditional versus nontraditional health care surrogates who are making medical decisions for pa...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000890
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Spinal mobilization and manipulation are 2 therapies found to be generally safe and effective for chronic low back pain (CLBP). However, the question remains whether they are appropriate for all CLBP patients. RESEARCH DESIGN:An expert panel used a well-validated approach, including an evidence synthesis an...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000001108
更新日期:2019-05-01 00:00:00
abstract::The authors conducted two studies of routine medical visits, investigating the relation of physician gender, patient gender, and physician age to patient satisfaction, and the correlations between communication behaviors and satisfaction separately for different combinations of patient and physician gender. Study 1 wa...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199412000-00005
更新日期:1994-12-01 00:00:00
abstract:OBJECTIVES:Veterans Health Administration encourages auricular acupuncture (Battlefield Acupuncture/BFA) as a nonpharmacologic approach to pain management. Qualitative reports highlighted a "gateway hypothesis": providing BFA can lead to additional nonpharmacologic treatments. This analysis examines subsequent use of t...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000001367
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Investigators have used a variety of operational definitions of nursing hours of care in measuring nurse staffing for health services research. However, little is known about which approach is best for nurse staffing measurement. OBJECTIVE:To examine whether various nursing hours measures yield different mo...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e318277eb50
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:The SF-12 is a multidimensional generic measure of health-related quality of life. It has become widely used in clinical trials and routine outcome assessment because of its brevity and psychometric performance, but it cannot be used in economic evaluation in its current form. OBJECTIVES:We sought to derive...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000135827.18610.0d
更新日期:2004-09-01 00:00:00
abstract::Issues that arise in the development of methods for measuring adequacy of physician performance (MAPP) are discussed. The comparative content validity, scorability, cost, and acceptability of four MAPP strategies are assessed using a sample of clinic-based physicians treating 30 patients with chronic obstructive pulmo...
journal_title:Medical care
pub_type: 临床试验,杂志文章
doi:
更新日期:1984-07-01 00:00:00
abstract:BACKGROUND:Various forms of differential item functioning (DIF) in the Mini-Mental State Examination (MMSE) have been identified. Items have been found to perform differently for individuals of different educational levels, racial/ethnic groups, and/or of groups whose first language is not English. The articles in this...
journal_title:Medical care
pub_type: 杂志文章,评审
doi:10.1097/01.mlr.0000245181.96133.db
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:Applying disease-specific guidelines to people with multimorbidity may result in complex regimens that impose treatment burden. OBJECTIVES:To describe and validate a measure of healthcare task difficulty (HCTD) in a sample of older adults with multimorbidity. RESEARCH DESIGN:Cross-sectional and longitudina...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3182a977da
更新日期:2014-03-01 00:00:00