Abstract:
BACKGROUND:This study is an evaluation of a discharge intervention that occurred in multiple hospitals across Maryland. In this program, patients received medications at their bedside before discharge with the goal of reducing the risk of primary nonadherence to prescribed medications. OBJECTIVE:To test if the intervention reduced the risk of 30-day readmission for the patients who received bedside medication delivery relative to comparable patients who did not receive bedside medication delivery. METHODS:This was a retrospective cohort study. Patients who received the intervention were linked to their claims data in the Maryland Health Information Exchange. These patients were matched on age, sex, diagnosis-related group, and hospital to a set of patients who did not receive the intervention. We used propensity score matching, as well as inverse-probability weighting, to account for residual differences between the treated and comparison patients. With robust Poisson regression, adjusting for hospital, we generated risk ratios for 30-day readmission and explored risk ratios in key subgroups. RESULTS:The cohort included 6,167 inpatients who received medications at bedside and 28,546 who did not from 10 Maryland hospitals. They were 60% female, 61% white, and 31% African American; the average age was 56 years. The risk ratio for readmission, comparing the intervention group to the propensity score-matched comparison group, was 1.21 (95% CI = 0.96-1.5). Inverse-probability weighting yielded a similar result (1.19 [95% CI = 0.98-1.45]). CONCLUSIONS:In this study, the isolated intervention of bedside medication delivery did not reduce 30-day readmission risk. We expect it may have favorable outcomes on other metrics such as primary nonadherence and patient satisfaction. It may also have a favorable effect when bundled with other care transition activities. As an isolated intervention, however, bedside medication delivery is unlikely to affect 30-day readmission rates. DISCLOSURES:This study was funded by Walgreen Co. through unrestricted funds to Johns Hopkins University, which has received fees from Walgreens for providing consultation as an institution to Walgreens. This arrangement has been reviewed and approved by the Johns Hopkins University in accordance with its conflict of interest policies. Segal received a grant from the National Institute on Aging during the conduct of this study. The other authors have nothing to disclose.
journal_name
J Manag Care Spec Pharmjournal_title
Journal of managed care & specialty pharmacyauthors
Segal JB,Apfel A,Brotman DJ,Shermock KM,Clark JMdoi
10.18553/jmcp.2020.26.3.296subject
Has Abstractpub_date
2020-03-01 00:00:00pages
296-304issue
3eissn
2376-0540issn
2376-1032journal_volume
26pub_type
杂志文章,多中心研究abstract:BACKGROUND:Employers have increased efforts to engage employees in health and wellness programs. Providing employees with incentives to participate in these programs has been shown to improve overall enrollment and engagement. One program that has had challenges with enrollment and engagement is medication therapy mana...
journal_title:Journal of managed care & specialty pharmacy
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doi:10.18553/jmcp.2017.23.11.1140
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abstract:BACKGROUND:Acromegaly is a chronic disorder characterized by excess growth hormone secretion and elevated insulin-like growth factor-1 levels most often caused by a pituitary adenoma. Clinical presentation of the disease includes coarsening of the facial features, soft-tissue swelling of the hands and feet, and overgro...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
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abstract:BACKGROUND:The management of schizophrenia, a chronic, multifaceted mental health condition, is associated with considerable health care resource utilization (HCRU) and costs. Current evidence indicates that a high-risk and costly prodromal period, during which patients are likely symptomatic, precedes diagnosis. Bette...
journal_title:Journal of managed care & specialty pharmacy
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doi:10.18553/jmcp.2019.25.10.1102
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abstract:BACKGROUND:Encouraging generic drug use has reduced health care costs for payers and consumers, but the availability of therapeutically interchangeable medications or generic medications of choice is not equal across disease states. The extent to which systems of care are able to substitute with generics is not well un...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2014.20.11.1093
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abstract:DISCLOSURES:No funding supported the writing of this letter. Preblick, Ali, and DasMahapatra are employees and shareholders of Sanofi Genzyme. Gray is a postdoctoral fellow at Sanofi Genzyme and Rutgers University. ...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 信件
doi:10.18553/jmcp.2020.26.9.1177
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Research describing patient experience and outcomes with extended half-life recombinant factor VIII (EHL rFVIII) outside of clinical trials is limited. Real-world rFVIII consumption studies, when people with hemophilia A (PWHA) switch from standard half-life (SHL) to EHL rFVIII, may help payers and clinician...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2020.26.4.492
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abstract:BACKGROUND:In 2013, it was reported that about 1 of every 3 U.S. adults has hypertension. Of these 70 million individuals, approximately 50% have their blood pressure under control. Achieving hypertension control, especially in at-risk populations, requires a multipronged approach that includes lifestyle modifications ...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2016.22.10.1116
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abstract::A panel of experts drawn from neurology, psychiatry, geropsychiatry, geriatrics, and pharmacy representatives of 3 health plans convened in New York City on July 30, 2016, with the objective of sharing opinions, ideas, and information regarding the optimal management of Parkinson's disease psychosis (PDP). Three key p...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章,评审
doi:10.18553/jmcp.2017.23.6-b.s2
更新日期:2017-06-01 00:00:00
abstract::Section 3002 of the 21st Century Cures Act, which was signed into law in December 2016, requires the FDA to develop one or more sets of new guidances regarding the collection of patient experience data. To explore how patient-reported outcomes (PROs) can support value-based care and discuss challenges to using PROs mo...
journal_title:Journal of managed care & specialty pharmacy
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journal_title:Journal of managed care & specialty pharmacy
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abstract:BACKGROUND:Nearly half of statin users discontinue therapy within the first year of treatment. Nonadherence to statin therapy may lead to an increased risk of atherosclerotic cardiovascular disease and, thus, higher costs due to hospitalizations. Value-based care models, such as accountable care organizations (ACO), ar...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2019.25.5.588
更新日期:2019-05-01 00:00:00
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journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2018.24.10.952
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Medication reconciliation is considered to be an important strategy for increasing the safety of medication use. However, few studies have been carried out showing the effect of a medication reconciliation program on the incidence of reconciliation errors (REs) in oncological patients treated in the outpatie...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章,随机对照试验
doi:10.18553/jmcp.2016.15248
更新日期:2016-06-01 00:00:00
abstract::BACKGROUND: Nonadherence and nonpersistence to antidepressants in major depressive disorder (MDD) are common and associated with poor clinical and functional outcomes and increased health care resource utilization (HCRU) and costs. However, contemporary real-world evidence on the economic effect of antidepressant nona...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2021.27.2.223
更新日期:2021-02-01 00:00:00
abstract::DISCLOSURES: Funding for the study referred to in this letter was contributed by Bayer Healthcare. Xia and Williamson are employees of Bayer Healthcare. Roth, Carlson, and Sullivan are consultants to Bayer Healthcare. Carlson also reports fees from Adaptive Biotechnologies, unrelated to the study. Roth reports consult...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 信件
doi:10.18553/jmcp.2020.26.12.1617
更新日期:2020-12-01 00:00:00
abstract::We write to comment on a recently published study by Delea et al. in the January 2015 issue of JMCP that evaluated the cost-effectiveness (CE) of sunitinib (SU) versus pazopanib (PAZ) as first-line treatment for metastatic renal cell carcinoma (mRCC) from a U.S. third-party payer perspective.1 This analysis was based ...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 评论,信件
doi:10.18553/jmcp.2015.21.9.834
更新日期:2015-09-01 00:00:00
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journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2015.21.8.678
更新日期:2015-08-01 00:00:00
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journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2017.23.1.27
更新日期:2017-01-01 00:00:00
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journal_title:Journal of managed care & specialty pharmacy
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doi:10.18553/jmcp.2020.20009
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journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2019.25.3.392
更新日期:2019-03-01 00:00:00
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journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
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更新日期:2015-12-01 00:00:00
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journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2018.24.6.504
更新日期:2018-06-01 00:00:00
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journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章,评审
doi:10.18553/jmcp.2019.25.12.1300
更新日期:2019-12-01 00:00:00
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journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2020.26.10.1297
更新日期:2020-10-01 00:00:00
abstract::BACKGROUND: Basal insulin is often recommended as the initial therapy for patients with type 2 diabetes who require insulin treatment. Adequate adherence is critical to diabetes management, yet suboptimal insulin adherence has been reported. Second-generation long-acting (SGLA) insulin has higher dosing flexibility an...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2020.26.11.1434
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:The implementation of Medicare Part D provided insurance coverage for outpatient medications, but when persons reach the "gap," they have very limited or no medication insurance coverage until they reach a second threshold for catastrophic coverage. In addition, some patients have a low-income subsidy (LIS),...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2014.20.8.862
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Psoriasis is a chronic, hyper-proliferative dermatological condition associated with joint symptoms known as psoriatic arthritis (PsA). In a 2013 review, the total economic burden of PsA was estimated at $51.7-$63.2 billion. The economic burden of moderate to severe psoriasis patients has reduced significant...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2018.24.7.654
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Rosacea is a chronic skin disorder that presents with abnormal vascular and inflammatory conditions. Clinical manifestations include flushing, facial erythema, inflammatory papules and pustules, telangiectasias, edema, and watery or irritated eyes. OBJECTIVE:To discuss the evolving pathophysiology of rosace...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章,评审
doi:10.18553/jmcp.2014.20.6.623
更新日期:2014-06-01 00:00:00
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journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2016.14251
更新日期:2016-02-01 00:00:00
abstract:DISCLOSURES:No funding was received for the writing of this commentary. The author has nothing to disclose. ...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2020.26.6.705
更新日期:2020-06-01 00:00:00