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https://www.readbyqxmd.com/read/28214168/medication-adherence-a-practical-measurement-selection-guide-using-case-studies
#1
Leah L Zullig, Phil Mendys, Hayden B Bosworth
OBJECTIVES: Medication adherence is a complex problem and can be evaluated using a variety of methods. There is no single or perfect strategy to assess adherence. The "best" measure depends on contextual factors. Our objective is to provide a practical, illustrative guide for selecting the most appropriate measure of medication adherence in common contexts. METHODS: We present three case studies - from the perspectives of an academic researcher, health care payer, and clinical care provider - to describe common problems and processes for measuring medication adherence, as well as proposing possible solutions...
February 10, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28212975/budget-impact-analysis-of-prolonged-half-life-recombinant-fviii-therapy-for-hemophilia-in-the-united-states
#2
Suzanne McMullen, Brieana Buckley, Eric Hall, Jon Kendter, Karissa Johnston
BACKGROUND: Hemophilia A is a factor VIII deficiency, associated with spontaneous, recurrent bleeding episodes. This may lead to comorbidities such as arthropathy and joint replacement, which contribute to morbidity and increased health care expenditure. Recombinant factor VIII Fc fusion protein (rFVIIIFc), a prolonged half-life factor therapy, requires fewer infusions, resulting in reduced treatment burden. OBJECTIVE: Use a budget impact analysis to assess the potential economic impact of introducing rFVIIIFc to a formulary from the perspective of a private payer in the United States...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28212967/decision-making-on-medical-innovations-in-a-changing-health-care-environment-insights-from-accountable-care-organizations-and-payers-on-personalized-medicine-and-other-technologies
#3
Julia R Trosman, Christine B Weldon, Michael P Douglas, Patricia A Deverka, John B Watkins, Kathryn A Phillips
BACKGROUND: New payment and care organization approaches, such as those of accountable care organizations (ACOs), are reshaping accountability and shifting risk, as well as decision making, from payers to providers, within the Triple Aim context of health reform. The Triple Aim calls for improving experience of care, improving health of populations, and reducing health care costs. OBJECTIVES: To understand how the transition to the ACO model impacts decision making on adoption and use of innovative technologies in the era of accelerating scientific advancement of personalized medicine and other innovations...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28212963/clinician-reported-outcome-assessments-of-treatment-benefit-report-of-the-ispor-clinical-outcome-assessment-emerging-good-practices-task-force
#4
John H Powers, Donald L Patrick, Marc K Walton, Patrick Marquis, Stefan Cano, Jeremy Hobart, Maria Isaac, Spiros Vamvakas, Ashley Slagle, Elizabeth Molsen, Laurie B Burke
A clinician-reported outcome (ClinRO) assessment is a type of clinical outcome assessment (COA). ClinRO assessments, like all COAs (patient-reported, observer-reported, or performance outcome assessments), are used to 1) measure patients' health status and 2) define end points that can be interpreted as treatment benefits of medical interventions on how patients feel, function, or survive in clinical trials. Like other COAs, ClinRO assessments can be influenced by human choices, judgment, or motivation. A ClinRO assessment is conducted and reported by a trained health care professional and requires specialized professional training to evaluate the patient's health status...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28212677/fit-for-purpose-perspectives-on-rapid-reviews-from-end-user-interviews
#5
Lisa Hartling, Jeanne-Marie Guise, Susanne Hempel, Robin Featherstone, Matthew D Mitchell, Makalapua L Motu'apuaka, Karen A Robinson, Karen Schoelles, Annette Totten, Evelyn Whitlock, Timothy J Wilt, Johanna Anderson, Elise Berliner, Aysegul Gozu, Elisabeth Kato, Robin Paynter, Craig A Umscheid
BACKGROUND: There is increasing demand for rapid reviews and timely evidence synthesis. The goal of this project was to understand end-user perspectives on the utility and limitations of rapid products including evidence inventories, rapid responses, and rapid reviews. METHODS: Interviews were conducted with key informants representing: guideline developers (n = 3), health care providers/health system organizations (n = 3), research funders (n = 1), and payers/health insurers (n = 1)...
February 17, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28210864/pharmacy-benefit-management-companies-do-they-create-value-in-the-us-healthcare-system
#6
Alan Lyles
Pharmacy benefit management companies (PBMs) perform functions in the US market-based healthcare system that may be performed by public agencies or quasi-public institutions in other nations. By aggregating lives covered under their many individual contracts with payers, PBMs have formidable negotiating power. They influence pharmaceutical insurance coverage, design the terms of coverage in a plan's drug benefit, and create competition among providers for inclusion in a plan's network. PBMs have, through intermediation, the potential to secure lower drug prices and to improve rational prescribing...
February 16, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28210350/use-of-physician-in-triage-model-in-the-management-of-abdominal-pain-in-an-emergency-department-observation-unit
#7
John R Marshall, Robert Katzer, Shahram Lotfipour, Bharath Chakravarthy, Siri Shastry, Jessica Andrusaitis, Craig L Anderson, Erik D Barton
INTRODUCTION: Given the nationwide increase in emergency department (ED) visits it is of paramount importance for hospitals to find efficient ways to manage patient flow. The purpose of this study was to determine whether there is a significant difference in success rates, length of stay (LOS), and other demographic factors in two cohorts of patients admitted directly to an ED observation unit (EDOU) under an abdominal pain protocol by a physician in triage (bypassing the main ED) versus those admitted via the traditional pathway (evaluated and treated in the main ED prior to EDOU admission)...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28209637/the-impact-of-payer-source-on-trauma-outcomes-in-a-pediatric-population
#8
Felecia A Lee, Ashley M Hervey, Arash Sattarin, Aaron Deeds, Gina M Berg, Kimberly Molik
OBJECTIVES: Determine if there were differences in conclusions drawn regarding disparities in trauma outcomes based on literature-derived payer source definitions in a pediatric population. PATIENTS AND METHODS: Retrospective registry review of admitted pediatric trauma patients (≤17 years of age) at a level II pediatric trauma facility. Eligible patients were categorized into 3 payer source definitions: definition 1: commercially insured, Medicaid, uninsured; definition 2: insured, uninsured; definition 3: commercially insured, underinsured...
February 16, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28209373/cost-utility-of-first-line-disease-modifying-treatments-for-relapsing-remitting-multiple-sclerosis
#9
Erkki Soini, Jaana Joutseno, Marja-Liisa Sumelahti
PURPOSE: This study evaluated the cost-effectiveness of first-line treatments of relapsing-remitting multiple sclerosis (RRMS) (dimethyl fumarate [DMF] 240 mg PO BID, teriflunomide 14 mg once daily, glatiramer acetate 20 mg SC once daily, interferon [IFN]-β1a 44 µg TIW, IFN-β1b 250 µg EOD, and IFN-β1a 30 µg IM QW) and best supportive care (BSC) in the health care payer setting in Finland. METHODS: The primary outcome was the modeled incremental cost-effectiveness ratio (ICER; €/quality-adjusted life-year [QALY] gained, 3%/y discounting)...
February 13, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28199029/healthcare-costs-of-type-2-diabetes-in-germany
#10
E Jacobs, A Hoyer, R Brinks, A Icks, O Kuß, W Rathmann
AIM: To describe for the first time the direct costs of Type 2 diabetes treatment by analysing nationwide routine data from statutory health insurance in Germany. METHODS: This cost-of-illness-study was based on a 6.8% random sample of all German people with statutory health insurance (4.3 out of 70 million people). The healthcare expenses show direct per capita costs from the payer perspective. Healthcare expenses for physicians, dentists, pharmacies, hospitals, sick benefits and other healthcare costs were considered...
February 15, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28196460/prescribing-of-clozapine-and-antipsychotic-polypharmacy-for-schizophrenia-in-a-large-medicaid-program
#11
Yan Tang, Marcela Horvitz-Lennon, Walid F Gellad, Judith R Lave, Chung-Chou H Chang, Sharon-Lise Normand, Julie M Donohue
OBJECTIVE: Underuse of clozapine and overuse of antipsychotic polypharmacy are both indicators of poor quality of care. This study examined variation in prescribing clozapine and antipsychotic polypharmacy across providers, as well as factors associated with these practices. METHODS: Using 2010-2012 Pennsylvania Medicaid data, prescribers were identified if they wrote antipsychotic prescriptions for ten or more nonelderly adult patients with schizophrenia annually...
February 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28196043/measures-of-the-appropriateness-of-elective-orthopaedic-joint-and-spine-procedures
#12
Jeffrey N Katz, Amelia R Winter, Gillian Hawker
Total knee arthroplasty and total hip arthroplasty are 2 of the most commonly performed elective orthopaedic procedures. They are remarkably successful in relieving pain and improving function in individuals with advanced, symptomatic arthritis. Since, in addition to providing benefits, these procedures pose risks, it is important to provide clinicians with guidance in determining which patients should undergo total joint replacement surgery. The development of the RAND approach in 1986 and its application to total hip and knee replacement have enabled clinicians, payers, and others to assess the appropriateness of past and current procedures for particular patients...
February 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28190669/insurance-status-affects-postoperative-morbidity-and-complication-rate-after-shoulder-arthroplasty
#13
Xinning Li, David R Veltre, Antonio Cusano, Paul Yi, David Sing, Joel J Gagnier, Josef K Eichinger, Andrew Jawa, Asheesh Bedi
BACKGROUND: Shoulder arthroplasty is an effective procedure for managing patients with shoulder pain secondary to end-stage arthritis. Insurance status has been shown to be a predictor of patient morbidity and mortality. The current study evaluated the effect of patient insurance status on perioperative outcomes after shoulder replacement surgery. METHODS: Data between 2004 and 2011 were obtained from the Nationwide Inpatient Sample. Analysis included patients undergoing shoulder arthroplasty (partial, total, and reverse) procedures determined by International Classification of Disease, 9th Revision procedure codes...
February 10, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28190600/cost-of-bleeding-related-episodes-in-adult-patients-with-primary-immune-thrombocytopenia-a-population-based-retrospective-cohort-study-of-administrative-claims-data-for-commercial-payers-in-the-united-states
#14
Junji Lin, Xinke Zhang, Xiaoyan Li, David Chandler, Ivy Altomare, Jeffrey S Wasser, Karynsa Cetin
PURPOSE: We estimated the real-world costs of bleeding-related episodes (BREs) in adults with primary immune thrombocytopenia (ITP). METHODS: This retrospective cohort study used the MarketScan Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefits databases. We identified adult patients diagnosed with primary ITP between 2007 and 2012, defined by at least 2 outpatient claims separated by ≥30 days or 1 inpatient claim (International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code for primary ITP [287...
February 9, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28188772/two-year-continuation-of-intrauterine-devices-and-contraceptive-implants-in-a-mixed-payer-setting-a-retrospective-review
#15
Jessica N Sanders, David K Turok, Lori M Gawron, Amy Law, Lonnie Wen, Richard Lynen
BACKGROUND: As the popularity of long-acting reversible contraception increases, so does the need for accurate data on method continuation in diverse clinical settings. We determined two-year continuation rates for the levonorgestrel 52mg intrauterine device, the copper T380A intrauterine device, and the 68mg etonogestrel contraceptive implant in an academic healthcare system with mixed-payer reimbursement. OBJECTIVE(S): To examine the proportion and characteristics of women who continue IUD and implant use to two years and relate continuation to device type when controlling for patient characteristics...
February 8, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28188191/payer-coverage-for-hereditary-cancer-panels-barriers-opportunities-and-implications-for-the-precision-medicine-initiative
#16
Julia R Trosman, Christine B Weldon, Michael P Douglas, Allison W Kurian, R Kate Kelley, Patricia A Deverka, Kathryn A Phillips
Background: Hereditary cancer panels (HCPs), testing for multiple genes and syndromes, are rapidly transforming cancer risk assessment but are controversial and lack formal insurance coverage. We aimed to identify payers' perspectives on barriers to HCP coverage and opportunities to address them. Comprehensive cancer risk assessment is highly relevant to the Precision Medicine Initiative (PMI), and payers' considerations could inform PMI's efforts. We describe our findings and discuss them in the context of PMI priorities...
February 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28187747/using-the-consolidated-framework-for-implementation-research-cfir-to-produce-actionable-findings-a-rapid-cycle-evaluation-approach-to-improving-implementation
#17
Rosalind E Keith, Jesse C Crosson, Ann S O'Malley, DeAnn Cromp, Erin Fries Taylor
BACKGROUND: Much research does not address the practical needs of stakeholders responsible for introducing health care delivery interventions into organizations working to achieve better outcomes. In this article, we present an approach to using the Consolidated Framework for Implementation Research (CFIR) to guide systematic research that supports rapid-cycle evaluation of the implementation of health care delivery interventions and produces actionable evaluation findings intended to improve implementation in a timely manner...
February 10, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28187056/operative-mortality-rates-of-acoustic-neuroma-surgery-a-national-cancer-database-analysis
#18
Shearwood McClelland, Ellen Kim, James D Murphy, Jerry J Jaboin
INTRODUCTION: Optimal acoustic neuroma (AN) management involves choosing between three treatment modalities: microsurgical excision, radiation, or observation with serial imaging. The reported in-hospital mortality rate of surgery for AN in the United States is 0.5%. However, there has yet to be a nationwide examination of the AN surgery mortality rate encompassing the period beyond initial hospital discharge. METHODS: The National Cancer Data Base (NCDB) from 2004 to 2013 identified AN patients receiving surgery...
February 9, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28185690/a-radiologist-s-guide-to-the-industry-a-methodical-approach-to-physician-industry-relationships-in-radiology
#19
Donald Dj Perry, Derek Khorsand, Michael McNeeley
In the last century, rapidly advancing technological innovations have become essential components of modern healthcare, increasing the frequency and necessity of interactions between physicians and industry. These interactions have the potential to bias objectivity and should be approached carefully. A recent JACR article by Harvey et al, highlighted 2014 CMS data, which reported that only 4% of radiologists had interactions with industry, coming in second lowest amongst all 19 reported specialties. However, when managed appropriately, physician-industry relationships can mutually benefit patients, research, payers, providers, hospitals and the medical industry...
December 15, 2016: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28183740/preventing-deaths-and-injuries-from-house-fires-a-cost-benefit-analysis-of-a-community-based-smoke-alarm-installation-programme
#20
Merissa A Yellman, Cora Peterson, Mary A McCoy, Shelli Stephens-Stidham, Emily Caton, Jeffrey J Barnard, Ted O Padgett, Curtis Florence, Gregory R Istre
BACKGROUND: Operation Installation (OI), a community-based smoke alarm installation programme in Dallas, Texas, targets houses in high-risk urban census tracts. Residents of houses that received OI installation (or programme houses) had 68% fewer medically treated house fire injuries (non-fatal and fatal) compared with residents of non-programme houses over an average of 5.2 years of follow-up during an effectiveness evaluation conducted from 2001 to 2011. OBJECTIVE: To estimate the cost-benefit of OI...
February 9, 2017: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
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