Abstract:
BACKGROUND:Prescription medication adherence is a known health-related barrier for elderly patients, leading to insufficient disease control and negative health outcomes. The Centers for Medicare & Medicaid Services (CMS) have placed significant emphasis on medication adherence, through the Part D star measures, revolving around treatment for chronic disease states such as hypertension, diabetes, and hyperlipidemia. However, it is unclear if physicians fully grasp the extent of nonadherence within their patient populations with regard to these medications, specifically those patients enrolled in Medicare Advantage Prescription Drug (MA-PD) plans. OBJECTIVES:To (a) determine physicians' perceptions of medication adherence among their patients enrolled in MA-PD plans and (b) compare those perceptions with actual adherence rates obtained from claims data. METHODS:A survey was developed and administered to primary care physicians (PCPs) contracted within a Texas MA-PD plan. The previously validated questionnaire was distributed during an all-PCP quarterly meeting and was collected prior to the meeting's conclusion to increase completion and return rates. PCPs were requested to indicate what percentage of their patients they believed to be adherent to each of the CMS Part D star medication classes, which includes statins, oral antidiabetic drugs (OADs), and reninangiotensin system (RAS) antagonists; what financial category they believe the majority of their patients fall under; and what percentage of their patients receive samples. The PCPs' perceived percentage of adherent patients were compared with the calculated percentage of patients, using a chi-square test at an a priori alpha level of 0.05. The calculated adherence was obtained from pharmacy claims data, meeting the CMS targeted adherence threshold (≥ 80%). This adherence rate was calculated using proportion of days covered (PDC) for all 3 medication categories in each PCP's patient population. RESULTS:To compare PCP perception of patient adherence and actual adherence, 226 PCPs were used. The sample population shared similar sex and age distribution with the national physician average; however, there was more racial diversity represented. PCP perception of patient adherence, as well as the actual percentage of adherent patients, were significantly (P < 0.05) different across statins, OADs, and RAS antagonists; lowest perceived percentage, as well as actual percentage, were reported for statins. PCP perception of patient adherence and actual percentage of adherent patients were significantly different in the 3 medication categories. PCPs' correct estimations were significantly (P < 0.0001) lower than expected values, while over- and underestimations were significantly (P < 0.0001) higher than the expected values. CONCLUSIONS:PCPs were almost equally likely to over- or underestimate percentage of adherent patients in their patient pools.
journal_name
J Manag Care Spec Pharmjournal_title
Journal of managed care & specialty pharmacyauthors
Winters A,Esse T,Bhansali A,Serna O,Mhatre S,Sansgiry Sdoi
10.18553/jmcp.2016.22.3.305subject
Has Abstractpub_date
2016-03-01 00:00:00pages
305-12issue
3eissn
2376-0540issn
2376-1032journal_volume
22pub_type
杂志文章abstract:BACKGROUND:Value-based insurance design attempts to align drug copayment tier with value rather than cost. Previous implementations of value-based insurance design have lowered copayments for drugs indicated for select "high value" conditions and have found modest improvements in medication adherence. However, these im...
journal_title:Journal of managed care & specialty pharmacy
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abstract:BACKGROUND:All Department of Veterans Affairs Medical Centers (VAMCs) operate under a single national drug formulary, yet substantial variation in prescribing and spending exists across facilities. Local management of the national formulary may differ across VAMCs and may be one cause of this variation. OBJECTIVE:To c...
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journal_title:Journal of managed care & specialty pharmacy
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journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2015.21.1.23
更新日期:2015-01-01 00:00:00
abstract::DISCLOSURES: No funding supported 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.2020.26.12.1612a
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Adherence to biologic disease-modifying antirheumatic drugs (bDMARDs) among patients with rheumatoid arthritis (RA) is often suboptimal in routine clinical practice. Low or nonadherence can reduce the effectiveness of bDMARD therapies. OBJECTIVE:To evaluate filling of newly prescribed initial bDMARDs for th...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2016.22.3.209
更新日期:2016-03-01 00:00:00
abstract::BACKGROUND: Measuring patient perspectives of the quality of health care delivery is an essential component of building a patient-centered model of care, which has garnered increasing emphasis under value-based payment models. Although measurements of patient perspectives of physician practices are common, few validat...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2021.27.1.105
更新日期:2021-01-01 00:00:00
abstract::It has been nearly 20 years since the Academy of Managed Care Pharmacy (AMCP) and other stakeholders adopted the Principles for a Sound Formulary System. Since that time, best practices for pharmacy and therapeutics (P&T) committees have matured throughout the health care system. On March 28, 2019, AMCP convened a gro...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 共识发展会议,杂志文章
doi:10.18553/jmcp.2020.26.1.48
更新日期:2020-01-01 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
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更新日期:2020-12-01 00:00:00
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更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Allergy immunotherapy (AIT) is the only available treatment that alters the natural course of allergies and has possible disease-modifying effects. AIT is administered primarily via subcutaneous injection delivered in a physician's office. Few studies have been conducted in the United States or Canada to eva...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章,多中心研究
doi:10.18553/jmcp.2015.21.11.982
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Tisagenlecleucel was approved for the treatment of pediatric and young adult patients with relapsed/refractory (r/r) B-cell acute lymphoblastic leukemia (ALL) based on the pivotal ELIANA trial. OBJECTIVE:To comprehensively evaluate the total costs associated with tisagenlecleucel treatment, including costs ...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2020.20052
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Costs associated with biologic switching and discontinuation can be high in chronic inflammatory diseases. Inappropriate use of medications may have cost implications for both payers and patients. Understanding of biologic utilization and switching rates is lacking among patients with ankylosing spondylitis ...
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pub_type: 杂志文章
doi:10.18553/jmcp.2020.19433
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Natalizumab disease-modifying therapy for relapsing-remitting multiple sclerosis (MS) is efficacious in randomized controlled trials. Few studies have estimated the association between real-world natalizumab persistence behavior and relapse-related outcomes. OBJECTIVES:To (a) examine the impact of using nat...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2015.21.3.210
更新日期:2015-03-01 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:2018-08-01 00:00:00
abstract:BACKGROUND:Concomitant use of stimulants and atypical antipsychotics is common in pediatric attention deficit hyperactivity disorder (ADHD). However, little is known about the determinants of concomitant use and its utility in the management of pediatric ADHD. OBJECTIVES:To (a) examine predictors of concomitant stimul...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2015.21.6.486
更新日期:2015-06-01 00:00:00
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
pub_type: 杂志文章
doi:10.18553/jmcp.2017.23.11.1140
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Diabetes requires close monitoring to achieve optimal outcomes and avoid adverse effects. Continuous glucose monitoring (CGM) is one approach to measuring glycemia and has become more widespread with recent advances in technology; however, ideal implementation of CGM into clinical practice is unknown. CGM ca...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2020.26.5.600
更新日期:2020-05-01 00:00:00
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 interve...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章,多中心研究
doi:10.18553/jmcp.2020.26.3.296
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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:Nonadherence to medication regimens can lead to adverse health care outcomes and increasing costs. OBJECTIVES:To (a) assess the level of medication complexity at an outpatient setting using population-level electronic health record (EHR) data and (b) evaluate its association with medication adherence measur...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
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更新日期:2020-07-01 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:2014-11-01 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:2020-02-01 00:00:00
abstract:BACKGROUND:Several authors have hypothesized that adverse drug events (ADEs) upon switching from reference biologics to biosimilar products are related to the nocebo effect. However, a thorough and current review of the existing literature has not been conducted. OBJECTIVE:To evaluate if patient and/or physician knowl...
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
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journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2017.23.1.64
更新日期:2017-01-01 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.2017.23.6.677
更新日期:2017-06-01 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.2019.25.3.304
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
doi:10.18553/jmcp.2017.16367
更新日期:2017-03-01 00:00:00
abstract::The ever-vulnerable medication supply chain is being further strained by the COVID-19 pandemic. Pharmacists in all settings, including managed care, will need to prepare for a potential exacerbation of existing and new drug shortages in the midst of unprecedented crisis. We summarize the major issues, discuss potentia...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2020.26.8.945
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Optimized medication use involves the effective use of medications for better outcomes, improved patient experience, and lower costs. Few studies systematically gather data on the actions accountable care organizations (ACOs) have taken to optimize medication use. OBJECTIVES:To (a) assess how ACOs optimize ...
journal_title:Journal of managed care & specialty pharmacy
pub_type: 杂志文章
doi:10.18553/jmcp.2017.23.10.1054
更新日期:2017-10-01 00:00:00