The Validity of Self-Reported Primary Adherence Among Medicaid Patients Discharged From the Emergency Department With a Prescription Medication

Ding, Ru; Zeger, Scott L.; Steinwachs, Donald M.; Ortmann, Melinda J.; McCarthy, Melissa L.

doi:10.1016/j.annemergmed.2013.01.026

Cited by 16 publications

(13 citation statements)

References 24 publications

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“…Over-thecounter products were associated with greater primary nonadherence (odds ratio, 3.6; 95% CI, 1.1-12.3; P = .04), consistent with previous studies. 21 While our study was not designed to determine the reasons for primary nonadherence, many patients offered unprompted reasons for not filling their prescriptions. Common justifications included cost, forgetfulness, similar treatments already on hand, not agreeing with the prescribed regimen, and improvement of skin condition before obtaining the prescriptions.…”

Section: Discussionmentioning

confidence: 99%

Frequency of Primary Nonadherence to Acne Treatment

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Frequency of Primary Nonadherence to Acne Treatment

et al. 2015

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“…Previous studies using pharmacy data to determine adult emergency department prescription fill rates showed rates ranging from 74-84%, 48,54,56 with one as low as 19.8%. 57 Since we only 36 looked at insured patients, it was expected that our fill rates would actually be higher than those seen previously.…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, Ding et al actually compared fill rates based on phone interviews versus pharmacy fill data for the same prescriptions and found that patients overreported their fill rates by 16%. 48 This literature seems to support a fill rate for adult emergency patients to be somewhere between 75-90%. An additional study looked at exclusively eprescriptions and found their fill rate to be 88%.…”

Section: Literature Review Of Emergency Patient Prescription Compliancementioning

confidence: 91%

“…It should also be noted that different methods of obtaining data were used in these studies and it has been shown that methods of self-report (telephone, survey, etc) are inaccurate as patients tend to inaccurately over-report their filling behavior. 48,49 Nonetheless, these fill rates help us establish a baseline that is important to this study. Table 1 shows a summary of these studies organized by year with the fill rates listed under the method used to obtain the data.…”

Section: Literature Review Of Emergency Patient Prescription Compliancementioning

confidence: 99%

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228 Comparison of Primary Compliance in Electronic Versus Paper Prescriptions Prescribed From the Emergency Department

Andrusaitis¹,

Billimek²,

Osborn³

et al. 2017

Annals of Emergency Medicine

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The Medicare Improvements for Patients and Providers Act passed by Congress in 2008has changed prescribing practices in the United States. Electronic prescriptions (e-prescriptions) have now become the most widely used form of prescriptions. The government in fact financially discourages the use of the older more traditional paper prescriptions.Many emergency medicine physicians fear that this blanket policy is not in the best interests of their unique patient population. It is the belief of many of these physicians that emergency patients are more likely to fill paper prescriptions than e-prescriptions. This theory is predicated on the knowledge that many emergency patients are less established in the system and their visits are frequently rushed, chaotic, and unplanned. For these reasons, the e-prescription system is not ideal for them and the theorized consequence is that many e-prescriptions go unfilled, leaving patients to go untreated.A retrospective analysis was conducted at the emergency department of the University of California, Irvine Medical Center to identify insured adult patients who were given a noncontrolled substance prescription in either the paper or electronic form. Pharmacy claim data to vi insurances was used to determine whether these prescriptions were filled. 405 encounters were included, 218 of which included e-prescriptions and 187 of which included paper prescriptions.Our findings showed that paper prescriptions are filled at the same rate as electronic prescriptions (58.3% versus 57.8% p=1). These results were surprising as they contradicted what many physicians believe is the situation. More studies are needed in order to be able to broaden these results to the entire emergency medicine patient population, but these results may begin to alter prescription practices in emergency medicine.

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“…The third study assessed self-reported prescription filling after an emergency department visit among Medicaid enrollees, comparing it to the pharmacy claims data as the gold standard. 24 According to patients, 90% of the prescriptions were filled (i.e. obtained by patients), but pharmacy claims data indicated that only 74% of the prescribed medications were filled.…”

Section: Primary Non-adherencementioning

confidence: 99%

Economic impact of waste in Prescribing, Dispensing, and Medication consumption in the United States

Almanie

Holdford

2015

Value in Health

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A81tool and disseminated it to a self-selected cohort of 11 small primary care practices that had previously achieved PCMH recognition from the NCQA. We assessed the cost of transformation between 2008 and 2011 using the tool. The cost of transformation was divided into four categories: the cost of NCQA patient centered recognition activities, the application cost of obtaining recognition, the cost of changes to practice culture, and the cost of external collaborations. Costs were averaged and weighted by the number of FTE providers in each practice in order to make the results comparable across practices. RESULTS: Three practices completed the tool. The weighted average cost of PCMH transformation was $35,508 per FTE provider in the year before recognition was achieved, and $38,218 in the recognition year itself. The most costly patient-centered activity (weighted average) in the pretransformation year was "providing self-care support" ($4,863/FTE provider), while "measuring and improving performance" ($9,503/FTE provider) was the most costly in the transformation year. CONCLUSIONS: The cost of recognition as a PCMH is a substantial but not insurmountable barrier to practice transformation. This information may be used by payers and policymakers to direct financial resources to primary care practices as they transform to the PCMH model. Indirect financial resources that assist in collecting cost data may also promote diffusion of the PCMH model.

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The Validity of Self-Reported Primary Adherence Among Medicaid Patients Discharged From the Emergency Department With a Prescription Medication

Cited by 16 publications

References 24 publications

Frequency of Primary Nonadherence to Acne Treatment

Frequency of Primary Nonadherence to Acne Treatment

228 Comparison of Primary Compliance in Electronic Versus Paper Prescriptions Prescribed From the Emergency Department

Economic impact of waste in Prescribing, Dispensing, and Medication consumption in the United States

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