Relationship Between Continuity of Ambulatory Care and Medication Adherence in Adult Patients With Type 2 Diabetes in Korea

Hong, Jae-Seok; Kang, Hee-Chung

doi:10.1097/mlr.0000000000000110

Cited by 43 publications

(49 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…) to interfere with patients’ ability to maintain appropriate supplies of chronic medications. Our findings are consistent with past studies showing that more outpatient providers (Chen, Tseng, and Cheng ; Hong and Kang ) and prescribers (Farley et al. ; Hansen et al.…”

Section: Discussionsupporting

confidence: 93%

“…Dual‐system prescription use may also impede patients’ ability to effectively manage and adhere to prescribed regimens. Patients obtaining prescriptions from multiple, disconnected providers may receive conflicting treatment plans and instructions or experience worse communication with providers, which may hinder their ability to consistently take and/or refill medications for chronic conditions (Chen, Tseng, and Cheng ; Hong and Kang ; Hansen et al. ).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Effect of Dual Use of Veterans Affairs and Medicare Part D Drug Benefits on Antihypertensive Medication Supply in a National Cohort of Veterans with Dementia

Thorpe

Gellad

Mor

et al. 2018

Health Services Research

View full text Add to dashboard Cite

Objective To evaluate the effect of dual use of VA/Medicare Part D drug benefits on antihypertensive medication supply in older Veterans with dementia. Data Sources/Study Setting National, linked 2007–2010 Veterans Affairs (VA) and Medicare utilization and prescription records for 50,763 dementia patients with hypertension. Study Design We used inverse probability of treatment (IPT)‐weighted multinomial logistic regression to examine the association of dual prescription use with undersupply and oversupply of antihypertensives. Data Collection/Extraction Methods Veterans Affairs and Part D prescription records were used to classify patients as VA‐only, Part D‐only, or dual VA/Part D users of antihypertensives and summarize their antihypertensive medication supply in 2010: (1) appropriate supply of all prescribed antihypertensive classes, (2) undersupply of ≥1 class with no oversupply of another class, (3) oversupply of ≥1 class with no undersupply, or (4) both undersupply and oversupply. Principal Findings Dual prescription users were more likely than VA‐only users to have undersupply only (aOR = 1.28; 95 percent CI = 1.18–1.39), oversupply only (aOR = 2.38; 95 percent CI = 2.15–2.64), and concurrent under‐ and oversupply (aOR = 2.89; 95 percent CI = 2.53–3.29), versus appropriate supply of all classes. Conclusions Obtaining antihypertensives through both VA and Part D was associated with increased antihypertensive under‐ and oversupply. Efforts to understand how best to coordinate dual‐system prescription use are critically needed.

show abstract

Section: Discussionsupporting

confidence: 93%

mentioning

confidence: 99%

Effect of Dual Use of Veterans Affairs and Medicare Part D Drug Benefits on Antihypertensive Medication Supply in a National Cohort of Veterans with Dementia

Thorpe

Gellad

Mor

et al. 2018

Health Services Research

View full text Add to dashboard Cite

show abstract

“…For example, despite the widespread recognition that psychosocial problems can impair diabetes management, and current American Diabetes Association (ADA) guidelines recommending routine psychosocial screening of all diabetes patients, many providers report insufficient training in assessment and management of psychological difficulties in their patients (41). In addition, many patients lack a consistent provider for diabetes care, creating significant frustration (27) and negatively affecting medication adherence and health outcomes (42,43). …”

Section: Adherence and Health Care Policy And Deliverymentioning

confidence: 99%

Seeing the Person, Not the Illness: Promoting Diabetes Medication Adherence Through Patient-Centered Collaboration

et al. 2017

View full text Add to dashboard Cite

IN BRIEF Nonadherence to diabetes medications is a primary contributor to health complications and avoidable hospitalizations. This article discusses the evidence for taking a person-centered (as opposed to illness-centered) approach to promoting medication adherence among diabetes patients, provides suggestions for ways in which diabetes clinicians can best promote medication adherence, and argues for needed changes in how health care systems support providers in their efforts at adherence promotion.

show abstract

“…[20][21][22] Studies that have used continuity within sites as a proxy for informational continuity suggest that informational continuity alone can improve medication adherence, and that there is an added benefit from interpersonal COC within sites in obtaining necessary preventive care. [23][24][25] Interpersonal COC does not, however, appear to improve cardiovascular risk management in an integrated delivery system. 26 To provide optimal care for complex patients, it is important to understand the contributions of interpersonal and informational continuity to outcomes.…”

Section: Introductionmentioning

confidence: 99%

Effect of Continuity of Care on Hospital Utilization for Seniors With Multiple Medical Conditions in an Integrated Health Care System

Bayliss

Ellis

Shoup

et al. 2015

The Annals of Family Medicine

114

View full text Add to dashboard Cite

PURPOSE Lower continuity of care has been associated with higher rates of adverse outcomes for persons with multiple chronic medical conditions. It is unclear, however, whether this relationship also exists within integrated systems that offer high levels of informational continuity through shared electronic health records. METHODSWe conducted a retrospective cohort study of 12,200 seniors with 3 or more chronic conditions within an integrated delivery system. Continuity of care was calculated using the Continuity of Care Index, which reflects visit concentration with individual clinicians. Using Cox proportional hazards regression permitting continuity to vary monthly until the outcome or censoring event, we separately assessed inpatient admissions and emergency department visits as a function of primary care continuity and specialty care continuity. RESULTSAfter adjusting for covariates (demographics; baseline, primary, and specialty care visits; baseline outcomes; and morbidity burden), greater primary care continuity and greater specialty care continuity were each associated with a lower risk of inpatient admission (respective hazard ratios (95% CIs) = 0.97 (0.96, 0.99) and 0.95 (0.93, 0.98)) and a lower risk of emergency department visits (respective hazard ratios = 0.97 (0.96, 0.98) and 0.98 (0.96, 1.00)). For the subgroup with 3 or more primary care and 3 or more specialty care visits, specialty care continuity (but not primary care continuity) was independently associated with a decreased risk of inpatient admissions (hazard ratio = 0.94 (0.92, 0.97)), and primary care continuity (but not specialty care continuity) was associated with a decreased risk of emergency department visits (hazard ratio = 0.98 (0.96, 1.00)). CONCLUSIONSIn an integrated delivery system with high informational continuity, greater continuity of care is independently associated with lower hospital utilization for seniors with multiple chronic medical conditions. Different subgroups of patients will benefit from continuity with primary and specialty care clinicians depending on their care needs. Ann Fam Med 2015;13:123-129. doi: 10.1370/afm.1739. INTRODUCTIONF or older patients with multiple chronic medical conditions (MCCs), greater morbidity is associated with higher rates of hospitalization, emergency service use, and receipt of outpatient care. [1][2][3][4] The older MCC population is also vulnerable to care fragmentation: such patients see more clinicians for both chronic and acute-on-chronic conditions. 5,6 This care fragmentation is risky as studies of older populations indicate that low continuity of care (COC) is associated with greater inappropriate medication prescribing, higher cost of care, more avoidable hospitalizations, greater use of emergency services, and higher all-cause mortality. [7][8][9][10][11][12][13] Several definitions of COC have been developed to capture the separate constructs of information exchange, longitudinal interpersonal relationships, and coordinated care that comprise care continuity.14...

show abstract

Relationship Between Continuity of Ambulatory Care and Medication Adherence in Adult Patients With Type 2 Diabetes in Korea

Cited by 43 publications

References 16 publications

Effect of Dual Use of Veterans Affairs and Medicare Part D Drug Benefits on Antihypertensive Medication Supply in a National Cohort of Veterans with Dementia

Effect of Dual Use of Veterans Affairs and Medicare Part D Drug Benefits on Antihypertensive Medication Supply in a National Cohort of Veterans with Dementia

Seeing the Person, Not the Illness: Promoting Diabetes Medication Adherence Through Patient-Centered Collaboration

Effect of Continuity of Care on Hospital Utilization for Seniors With Multiple Medical Conditions in an Integrated Health Care System

Contact Info

Product

Resources

About