Assessing the association between medication adherence, as defined in quality measures, and disease-state control, health care utilization, and costs in a retrospective database analysis of Medicare supplemental beneficiaries using statin medications

Axon, David R.; Vaffis, Shannon; Chinthammit, Chanadda; Lott, Breanne E.; Taylor, Ann M.; Pickering, Matthew; Black, Heather; Warholak, Terri; Campbell, Patrick

doi:10.18553/jmcp.2020.26.12.1529

Cited by 9 publications

(5 citation statements)

References 13 publications

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“…An important study limitation is that beyond analysing PDC, our model did not assess the quality of care that patients with chronic hypertension received. Studies from a range of other specialties demonstrated that optimal longitudinal healthcare use may be associated with decreased risk 28,29 . These longitudinal care use models have not been translated to the obstetric population and the effect of care quality in accounting for risk is unknown.…”

Section: Discussionmentioning

confidence: 99%

“…Studies from a range of other specialties demonstrated that optimal longitudinal healthcare use may be associated with decreased risk. 28,29 These longitudinal care use models have not been translated to the obstetric population and the effect of care quality in accounting for risk is unknown. Second, our inclusion criteria may have disproportionately sampled Medicaid patients with higher comorbidity.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

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Risk for adverse maternal outcomes among women with chronic hypertension

Yang

Friedman

Krenitsky

et al. 2023

BJOG

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Objective To determine whether longitudinal health data accounts for end‐organ injury or death in the setting of chronic hypertension. Design Cohort of 64 799 deliveries to 61 854 women. Setting US claims data for the preiod 2008–2019. Population Women with a delivery hospitalisation and chronic hypertension. Methods Risk for a composite of acute end‐organ injury or death during the delivery hospitalisation and 30 days postpartum was analysed. Adjusted logistic regression models were derived with discrimination for each model estimated by the C‐statistic. Poisson regression was used to estimate adjusted risk ratios. Starting with models using data from pregnancy, further adjustment was performed accounting for healthcare use in the year prior to pregnancy, including hospitalisations, emergency department encounters, prescription medications and pre‐pregnancy diagnoses. Main outcome measures Acute end‐organ injury or death. Results The composite outcome occurred among 5.7% of 64 799 deliveries. For patients with commercial insurance, filling non‐hypertensive medications from ≥11 different classes, compared with none (adjusted risk ratio, aRR 4.07, 95% CI 2.86–5.79), three or more hospitalisations before pregnancy, compared with none (aRR 4.75, 95% CI 3.46–6.52), and chronic kidney disease diagnosed in the year before pregnancy (aRR 2.35, 95% CI 1.88, 2.94) were associated with increased risk. For pregnancies covered by commercial insurance, the C‐statistic increased from 0.615 (95% CI 0.599–0.630) in the model with pregnancy data only to 0.796 (95% CI 0.783–0.808) for the model additionally including healthcare use in the year before pregnancy. Findings with Medicaid were similar. Conclusions Prepregnancy care use predicted adverse maternal outcomes. These data may be important in risk stratification.

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Section: Discussionmentioning

confidence: 99%

Section: Strengths and Limitationsmentioning

confidence: 99%

Risk for adverse maternal outcomes among women with chronic hypertension

Yang

Friedman

Krenitsky

et al. 2023

BJOG

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“…На отечественном рынке можно выделить устройства фирмы BRADEX 4 каждая ячейка может вместить до 18 таблеток). Такая таблетница может быть удобна для использования в домашних условиях, но ее размер позволяет сделать предположение о статусе здоровья владельца.…”

Section: таблетницы и сумкиunclassified

“…Axon и соавт. [4] продемонстрировано, что соблюдение режима фармакотерапии (не менее 80% от общего числа приема ЛП) даже в течение 1 года снижало затраты на здравоохранение у пациентов, принимавших статины. Похожие исследования проводились для групп пациентов с сахарным диабетом [5] и гипертонией [6], во всех случаях было отмечено снижение общих расходов на лечение.…”

Section: Introductionunclassified

Digital Pharmacotherapy Support for Medication Adherence

Zaveryachev,

Lotnik,

Gilavyan

et al. 2023

Bezopasnost' i risk farmakoterapii

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Scientific relevance. Medication adherence is an important condition for effective and safe treatment. The adherence of patients to prescriptions is tracked by assessing their condition, counting the pills taken, and using other indirect methods. Digital technologies can help healthcare providers improve their patients’ medication adherence.Aim. The authors aimed to review literature describing the medication adherence impact on treatment effectiveness, as well as digital solutions accompanying pharmacotherapy.Discussion. Poor adherence to treatment is a significant risk factor for patients. The most common examples of poor adherence are omissions and delays in the timing of doses. Compared with classical daily dosing, individualised regimens significantly increase the risk of adherence errors. Significant consequences of non-adherence include exacerbation of the disease, insufficient effectiveness of treatment, adverse drug reactions, and drug resistance. Promising hardware and software approaches to supporting medication adherence include innovative technological solutions (pillboxes, bottles with electronic reminder systems, digital pills, and smart medication adherence monitoring systems), mobile apps, and chatbots.Conclusions. Digital solutions to support pharmacotherapy help improve patients’ adherence to their dosing regimens and individualise their treatment. Further research is needed to select the most promising areas and develop novel digital technologies.

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“… 6–8 A recent meta-analysis indicated that adherence to statins has been shown to improve outcomes and reduce health care cost. 9 Adherence to medication regimens has been associated with reduced hospitalization and health care costs in patients with chronic illnesses that include diabetes mellitus, hypercholesterolemia, hypertension, and congestive heart failure. 10 Maintaining adherence to medication regimens can be a challenge, especially in patients with a high pill burden.…”

Section: Introductionmentioning

confidence: 99%

An Analysis of Medication Adherence in a Large Outpatient Population During the COVID-19 Pandemic Using a Novel Value-Based Pharmacy System

Hefti

Xie

Engelen

2024

Telemedicine and e-Health

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Background: Adherence to a medication regimen is defined as taking the medication as directed by the prescriber. Adherence is critical to achieve the desired therapeutic outcomes. Medication adherence has not been examined in large outpatient populations since the onset of the COVID-19 pandemic. A novel outpatient value-based pharmacy system (VPS) was used to collect adherence data from a large, outpatient population. The aim of this descriptive study was to analyze the reasons, medication classes, and diagnoses associated with nonadherence. Materials and Methods: Telepharmacist-documented adherence data from a large ( n = 6,479) outpatient population that received remote consultation during the COVID-19 pandemic (August 1, 2020–November 28, 2022) were considered for this study. The adherence data were compiled within the VPS. Results: The overall rate of patients reporting at least one incident of nonadherence to their medication regimens was 21.5%. Medications used to treat hypertension, type 2 diabetes, and hyperlipidemia were least adhered to. Statins, beta-2 agonists, and corticosteroids were least adhered to. The most common reasons for nonadherence included knowledge gaps regarding therapy, forgetfulness, and side effects. Discussion: This represents the first descriptive analyses of adherence metrics in a large outpatient population during the COVID-19 pandemic. Polypharmacy, prevalence of diagnosis, and medication side effect profile may have contributed to the results observed. This study demonstrates the ability of a VPS to document key data to better inform the health care team. Elucidating adherence metrics in such populations may allow pharmacists and prescribers to identify subpopulations that require further education and management.

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Assessing the association between medication adherence, as defined in quality measures, and disease-state control, health care utilization, and costs in a retrospective database analysis of Medicare supplemental beneficiaries using statin medications

Abstract: Assessing the association between medication adherence, as defined in quality measures, and disease-state control, health care utilization, and costs in a retrospective database analysis of Medicare supplemental beneficiaries using statin medications 1530

Cited by 9 publications

References 13 publications

Risk for adverse maternal outcomes among women with chronic hypertension

Risk for adverse maternal outcomes among women with chronic hypertension

Digital Pharmacotherapy Support for Medication Adherence

An Analysis of Medication Adherence in a Large Outpatient Population During the COVID-19 Pandemic Using a Novel Value-Based Pharmacy System

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