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https://www.readbyqxmd.com/read/29049904/the-impact-of-medicare-part-d-on-cognitive-functioning-at-older-ages
#1
Tae-Young Pak, GwanSeon Kim
Research has shown that the establishment of Medicare prescription drug benefit in 2006 leads to improvement in medication adherence and mortality outcomes. Despite a clear connection between physical/mental health and the risk of dementia, little is known about the extent to which this reform has affected the cognitive functioning of the elderly. Using data from the Health and Retirement Study and difference-in-differences approach, this study provides the first evidence on the cognition-enhancing effects of Medicare Part D...
September 25, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/29043521/initiation-of-antihypertensive-monotherapy-and-incident-fractures-among-medicare-beneficiaries
#2
Jennifer L Hargrove, Yvonne M Golightly, Virginia Pate, Carri H Casteel, Laura R Loehr, Stephen W Marshall, Til Stürmer
BACKGROUND: Research suggests antihypertensive medications are associated with fractures in older adults, however results are inconsistent and few have examined how the association varies over time. We sought to examine the association between antihypertensive class and incident non-vertebral fractures among older adults initiating monotherapy according to time since initiation. METHODS: We used a new-user cohort design to identify Medicare beneficiaries (≥ 65 years of age) initiating antihypertensive monotherapy during 2008-2011 using a 20% random sample of Fee-For-Service Medicare beneficiaries enrolled in parts A (inpatient services), B (outpatient services), and D (prescription medication) coverage...
October 18, 2017: Injury Epidemiology
https://www.readbyqxmd.com/read/28992824/a-nationwide-study-of-pharmacists-perception-of-the-impact-of-medicare-part-d-on-the-pharmacist-patient-relationship
#3
Joshua J Spooner, Harlan Spotts, Shamima Khan
BACKGROUND: Medicare Part D was implemented in 2006, introducing change to the community pharmacy marketplace, with profound disruption to independent pharmacy operations across the United States. AIMS: To understand pharmacist perceptions about Part D and their perceived obligation to address Part D issues on behalf of their beneficiaries. METHODS: A nationwide, cross-sectional survey of pharmacists was conducted between April and July 2013...
October 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28990452/do-medicare-beneficiaries-living-with-hiv-aids-choose-prescription-drug-plans-that-minimize-their-total-spending
#4
Katherine A Desmond, Thomas H Rice, Arleen A Leibowitz
This article examines whether California Medicare beneficiaries with HIV/AIDS choose Part D prescription drug plans that minimize their expenses. Among beneficiaries without low-income supplementation, we estimate the excess cost, and the insurance policy and beneficiary characteristics responsible, when the lowest cost plan is not chosen. We use a cost calculator developed for this study, and 2010 drug use data on 1453 California Medicare beneficiaries with HIV who were taking antiretroviral medications. Excess spending is defined as the difference between projected total spending (premium and cost sharing) for the beneficiary's current drug regimen in own plan vs spending for the lowest cost alternative plan...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28983558/association-between-opioid-prescribing-patterns-and-abuse-in-ophthalmology
#5
Shriji Patel, Paul Sternberg
Importance: Drug overdoses have become the number 1 cause of mortality in American adults 50 years and younger. Prescription opioid abuse is a growing concern that has garnered widespread attention among policymakers and the general public. Objective: To determine the opioid prescribing patterns among ophthalmologists and elucidate their role in the prescription opioid abuse epidemic. Design, Setting, and Participants: In this observational cohort study, beneficiaries and their physicians were analyzed using 2013 to 2015 Medicare Part D Prescriber Data...
October 5, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28978563/potential-medication-related-problems-in-older-breast-colon-and-lung-cancer-patients-in-the-united-states
#6
Jennifer L Lund, Hanna K Sanoff, Sharon Peacock-Hinton, Hyman Muss, Virginia Pate, Til Stürmer
BACKGROUND: Older adults are often exposed to multiple medications, some of which could be inappropriate or have the potential to interact with each other. Older cancer patients may be at increased risk for medication-related problems due to exposure to cancer-directed treatment. METHODS: We described patterns of potentially inappropriate medication (PIM) use and potential drug-chemotherapy interactions among adults age 66+ years diagnosed with stage I-III breast, stage II-III colon, and stage I-II lung cancer...
October 4, 2017: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/28976559/adherence-to-tyrosine-kinase-inhibitors-among-medicare-part-d-beneficiaries-with-chronic-myeloid-leukemia
#7
Chan Shen, Bo Zhao, Lei Liu, Ya-Chen Tina Shih
BACKGROUND: Tyrosine kinase inhibitors (TKIs) improve the survival of patients with chronic myeloid leukemia (CML) dramatically; however, nonadherence to TKI therapy may lead to resistance to the therapy. TKIs are very expensive and are covered under Part D insurance for Medicare patients. To the authors' knowledge, the impact of low-income subsidy status and cost sharing on adherence among this group has not been well studied in the literature. METHODS: Surveillance, Epidemiology, and End Results (SEER) registry data linked with Medicare Part D data from the years 2007 through 2012 were used in the current study...
October 4, 2017: Cancer
https://www.readbyqxmd.com/read/28969046/gene-methylation-biomarkers-in-sputum-as-a-classifier-for-lung-cancer-risk
#8
Shuguang Leng, Guodong Wu, Donna M Klinge, Cynthia L Thomas, Elia Casas, Maria A Picchi, Christine A Stidley, Sandra J Lee, Seena Aisner, Jill M Siegfried, Suresh Ramalingam, Fadlo R Khuri, Daniel D Karp, Steven A Belinsky
CT screening for lung cancer reduces mortality, but will cost Medicare ∼2 billion dollars due in part to high false positive rates. Molecular biomarkers could augment current risk stratification used to select smokers for screening. Gene methylation in sputum reflects lung field cancerization that remains in lung cancer patients post-resection. This population was used in conjunction with cancer-free smokers to evaluate classification accuracy of a validated eight-gene methylation panel in sputum for cancer risk...
September 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28966696/comparing-adoption-of-breakthrough-and-me-too-drugs-among-medicare-beneficiaries-a-case-study-of-dipeptidyl-peptidase-4-inhibitors
#9
Inmaculada Hernandez, Yuting Zhang
PURPOSE: "Me-too" drugs are new pharmaceuticals with the mechanism of action of an existing drug and are considered less innovative than breakthrough drugs. The objective of this study was to evaluate whether the adoption patterns of the breakthrough drug sitagliptin and the "me-too" drug saxagliptin differed; and to assess whether the patterns differed between Medicare stand-alone (PDP) and Medicare-Advantage Part D (MA-PD) plans. METHODS: Pharmacy claims from a 5% random sample of Medicare Part D beneficiaries were used to identify all prescriptions filled for sitagliptin (breakthrough drug) and saxagliptin ("me-too" drug) between October 1, 2006 and December 31, 2011...
June 2017: Journal of Pharmaceutical Innovation
https://www.readbyqxmd.com/read/28958013/fracture-risk-assessment-in-long-term-care-frail-development-and-validation-of-a-prediction-model
#10
Sarah D Berry, Andrew R Zullo, Yoojin Lee, Vincent Mor, Kevin W McConeghy, Geetanjoli Banerjee, Ralph B D'Agostino, Lori Daiello, David Dosa, Douglas P Kiel
Background: Strategies used to predict fracture in community-dwellers may not be useful in the nursing home (NH). Our objective was to develop and validate a model (Fracture Risk Assessment in Long-term Care [FRAiL]) to predict the 2-year risk of hip fracture in NH residents using readily available clinical characteristics. Methods: The derivation cohort consisted of 419,668 residents between May 1, 2007 and April 30, 2008 in fee-for service Medicare. Hip fractures were identified using Part A diagnostic codes...
August 31, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28940193/prevalence-of-long-term-opioid-use-in-long-stay-nursing-home-residents
#11
Jacob N Hunnicutt, Stavroula A Chrysanthopoulou, Christine M Ulbricht, Anne L Hume, Jennifer Tjia, Kate L Lapane
BACKGROUND/OBJECTIVES: Overall and long-term opioid use among older adults have increased since 1999. Less is known about opioid use in older adults in nursing homes (NHs). DESIGN: Cross-sectional. SETTING: U.S. NHs (N = 13,522). PARTICIPANTS: Long-stay NH resident Medicare beneficiaries with a Minimum Data Set 3.0 (MDS) assessment between April 1, 2012, and June 30, 2012, and 120 days of follow-up (N = 315,949). MEASUREMENTS: We used Medicare Part D claims to measure length of opioid use in the 120 days from the index assessment (short-term: ≤30 days, medium-term: >30-89 days, long-term: ≥90 days), adjuvants (e...
September 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28935814/diabetes-treatments-and-risks-of-adverse-breast-cancer-outcomes-among-early-stage-breast-cancer-patients-a-seer-medicare-analysis
#12
Lu Chen, Jessica Chubak, Denise M Boudreau, William E Barlow, Noel S Weiss, Christopher I Li
The widely prescribed diabetes medicine metformin has been reported to lower the risk of incident breast cancer, but it is unclear if it affects malignant progression after diagnosis. In this study, we conducted a retrospective cohort study using the linked Surveillance, Epidemiology and End-Results (SEER)-Medicare database. Women were included in the study if they were aged 66-80 years, newly diagnosed with stage I or II breast cancer, and enrolled in Medicare Parts A, B, and D during 2007-2011. Information on dispensed diabetes-related medications was obtained from Medicare Part D claims data...
September 21, 2017: Cancer Research
https://www.readbyqxmd.com/read/28935654/opioid-prescription-morbidity-and-mortality-in-united-states-dialysis-patients
#13
Paul L Kimmel, Chyng-Wen Fwu, Kevin C Abbott, Anne W Eggers, Prudence P Kline, Paul W Eggers
Aggressive pain treatment was advocated for ESRD patients, but new Centers for Disease Control and Prevention guidelines recommend cautious opioid prescription. Little is known regarding outcomes associated with ESRD opioid prescription. We assessed opioid prescriptions and associations between opioid prescription and dose and patient outcomes using 2006-2010 US Renal Data System information in patients on maintenance dialysis with Medicare Part A, B, and D coverage in each study year (n=671,281, of whom 271,285 were unique patients)...
September 21, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28929867/innovation-productivity-and-pricing-capturing-value-from-precision-medicine-technology-in-canada
#14
J C Herbert Emery, Jennifer D Zwicker
For new technology and innovation such as precision medicine to become part of the solution for the fiscal sustainability of Canadian Medicare, decision-makers need to change how services are priced rather than trying to restrain emerging technologies like precision medicine for short-term cost savings. If provincial public payers shift their thinking to be public purchasers, value considerations would direct reform of the reimbursement system to have prices that adjust with technologically driven productivity gains...
July 2017: Healthcare Management Forum
https://www.readbyqxmd.com/read/28925664/preventing-falls-in-older-persons
#15
Lainie Van Voast Moncada, L Glen Mire
The American Geriatrics Society and British Geriatrics Society recommend that all adults older than 65 years be screened annually for a history of falls or balance impairment. The U.S. Preventive Services Task Force and American Academy of Family Physicians recommend exercise or physical therapy and vitamin D supplementation to prevent falls in community-dwelling older adults who are at increased risk of falls. Although the U.S. Preventive Services Task Force and American Academy of Family Physicians do not recommend routine multifactorial intervention to prevent falls in all community-dwelling older adults, they state that it may be appropriate in individual cases...
August 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28918956/healthcare-utilization-and-expenditures-for-united-states-medicare-beneficiaries-with-systemic-vasculitis
#16
Carolyn T Thorpe, Joshua M Thorpe, Tao Jiang, Dylan Atkinson, Yihuang Kang, Loren J Schleiden, Delesha M Carpenter, Julie Anne G McGregor, Susan L Hogan
OBJECTIVE: The Medicare federal insurance program is the most common United States insurer of patients with systemic vasculitis (SV). We compared healthcare utilization and expenditures for Medicare beneficiaries with versus without SV. METHODS: This national, retrospective study used 2010 claims and enrollment data for a 100% cohort of Medicare Part A and B beneficiaries with ≥1 claim including a diagnosis for a form of SV (n = 176,498), and a randomly selected group of non-SV beneficiaries (n = 46,561)...
August 10, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/28903137/nationwide-coverage-and-cost-sharing-for-pcsk9-inhibitors-among-medicare-part-d-plans
#17
Dhruv S Kazi, Christine Y Lu, Grace A Lin, Colette DeJong, R Adams Dudley, Randi Chen, Chien-Wen Tseng
No abstract text is available yet for this article.
October 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28872535/the-opportunity-awaits-to-lead-orthopaedic-telehealth-innovation-aoa-critical-issues
#18
Montri D Wongworawat, Gary Capistrant, John M Stephenson
Telehealth is a way to provide health-care services to a patient from a provider who is at another location. The most common methods include a live interactive visit with the patient, interpretation of imaging, and monitoring of patient progress. Principally, telehealth is a way of providing a service rather than a type of service. It is about patient care, not data care.Examples of orthopaedic applications include conducting patient examinations, interpreting imaging studies, and providing postoperative care...
September 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28817295/does-the-offer-of-free-prescriptions-increase-generic-prescribing
#19
Bruce Stuart, Franklin Hendrick, J Samantha Dougherty, Jing Xu
OBJECTIVES: To test if offering zero generic co-pays for oral antidiabetic drugs (OADs) and statins increases generic dispensing for low-income subsidy (LIS) recipients with diabetes enrolled in Medicare Part D. STUDY DESIGN: We analyzed a natural experiment in which LIS recipients were randomized to Part D plans in 2008. Some plans placed selected generic OADs and statins on zero co-pay tiers whereas others did not. Randomization eliminated selection effects which could bias the study findings...
June 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28807926/use-of-antihypertensive-medications-and-risk-of-adverse-breast-cancer-outcomes-in-a-seer-medicare-population
#20
Lu Chen, Jessica Chubak, Denise M Boudreau, William E Barlow, Noel S Weiss, Christopher I Li
BACKGROUND: It is unclear if use of common antihypertensive medications influences the risk of adverse breast cancer outcomes. METHODS: Using the linked Surveillance, Epidemiology and End-Results (SEER)-Medicare database, we identified 14,766 women between ages 66 and 80 years diagnosed with incident stage I/II breast cancer between 2007-2011. Medicare Part D data were obtained to characterize women's post-cancer use of various antihypertensive medications. Outcomes included a second breast cancer event (SBCE, a composite outcome defined as the first of a recurrence or a second contralateral primary breast cancer), breast cancer recurrence, and breast-cancer specific mortality...
August 14, 2017: Cancer Epidemiology, Biomarkers & Prevention
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