When treatment options are being considered, this study suggests that use of LPV/r in the first antiretroviral regimen, as compared to NFV, is cost-effective based on improved efficacy and resistance.
Diabetes management services from clinical pharmacists achieved significant improvements in A1C values, blood pressure, and aspirin use. Continued efforts in diabetes education and management are needed to further improve clinical, economic, and humanistic outcomes.
Based on this model, sildenafil is a cost-effective treatment for PAH with a low price and a net increase in QALYs. The results from this analysis are a tool to help guide clinicians in deciding which PAH medications to use; however, the final decisions should be individualized because the effectiveness of therapy, resulting utilities and acceptable costs will differ with each patient.
Background:Medication adherence is an integral aspect of disease state management for
patients with chronic illnesses, including diabetes mellitus. It has been
hypothesized that patients with diabetes who have poor medication adherence
may have less knowledge of overall therapeutic goals and may be less likely
to attain these goals.Objective:The purpose of this study was to assess self-reported medication adherence,
knowledge of therapeutic goals (hemoglobin A1C [A1C], low density
lipoprotein cholesterol [LDL-C] and blood pressure [BP]), and goal
attainment in adult patients with diabetes.Methods:A survey was created to assess medication adherence, knowledge of therapeutic
goals, and goal attainment for adult patients with diabetes followed at an
internal medicine or a family medicine clinic. Surveys were
self-administered prior to office visits. Additional data were collected
from the electronic medical record. Statistical analysis was performed.Results:A total of 149 patients were enrolled. Knowledge of therapeutic goals was
reported by 14%, 34%, and 18% of survived patients for
LDL-C, BP, and A1C, respectively. Forty-six percent, 37%, and
40% of patients achieved LDL-C, BP, and A1C goals, respectively. Low
prescribing of cholesterol-lowering medications was an interesting secondary
finding; 36% of patients not at LDL-C goal had not been prescribed a
medication targeted to lower cholesterol. Forty-eight percent of patients
were medication non-adherent; most frequently reported reasons for
non-adherence were forgot (34%) and too expensive (14%).
Patients at A1C goal were more adherent than patients not at goal
(p=0.025).Conclusion:The majority did not reach goals and were unknowledgeable of goals; however,
most were provided prescriptions to treat these parameters. Goal parameters
should be revisited often amongst multidisciplinary team members with
frequent and open communications. Additionally, it is imperative that
practitioners discuss the importance of medication adherence with every
patient at every visit.
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