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Medication adherance statin

Corey A Lester, Kevin A Look, Michelle A Chui
BACKGROUND: The Centers for Medicare & Medicaid Services (CMS) adopted the proportion of days covered (PDC) calculation for use in their Five-Star Quality Rating System for Medicare Advantage and Prescription Drug Plans. This calculation uses the prescription adjudication date (i.e., date the prescription is billed to the benefits manager by a pharmacy) as a proxy for medication adherence. Adherence programs, such as automatic refill programs, have become commonplace in community pharmacy and have been identified by industry leaders as interfering with the ability to accurately measure adherence using PDC...
November 2016: Journal of Managed Care & Specialty Pharmacy
Yu Karpov, N Logunova, D Tomilova, V Buza, Yu Khomitskaya
OBJECTIVE: The OPTIMA II study sought to evaluate rates of major adverse cardiac and cerebrovascular events (MACCE) during the long-term follow-up of chronic statin users who underwent percutaneous coronary intervention (PCI) with implantation of a drug-eluting stent (DES). RESEARCH DESIGN AND METHODS: OPTIMA II was a non-interventional, observational study conducted at a single center in the Russian Federation. Included patients were aged ≥18 years with stable angina who had received long-term (≥1 month) statin therapy prior to elective PCI with DES implantation and who had participated in the original OPTIMA study...
October 25, 2016: Current Medical Research and Opinion
Dorairaj Prabhakaran
Among individuals with established CVD, multiple medications (aspirin, blood pressure lowering drugs and statins) are required to manage CVD and it is well established that non adherence to prescribed treatments is substantial in the long term. Such discontinuation of CV-preventive medications and low adherence rates has been shown to affect the success of CVD prevention efforts. In low- and middle income countries only less than 20% patients receive recommended therapy for CVD prevention, but even in high-income countries treatment coverage in the community is only about 50% in those with heart disease and 35% in those with stroke...
September 2016: Journal of Hypertension
Manuela Casula, Lorenza Scotti, Elena Tragni, Luca Merlino, Giovanni Corrao, Alberico L Catapano
BACKGROUND AND AIMS: We aimed at describing the therapeutic approach in young adult patients diagnosed with heterozygous familial hypercholesterolemia (HeFH) and their adherence and persistence to treatment. METHODS: From regional administrative databases, individuals aged ≤40 years, who received exemption for HeFH between January 1, 2003 and December 31, 2011, and concomitantly started statin treatment, were identified. Within the first year of treatment, we evaluated therapeutic changes, adherence as MPR (medication possession ratio), persistence as continuous drug coverage without gaps ≥60 days, and influencing factors using log binomial models...
October 12, 2016: Atherosclerosis
Amitava Banerjee, Shweta Khandelwal, Lavanya Nambiar, Malvika Saxena, Victoria Peck, Mohammed Moniruzzaman, Jose Rocha Faria Neto, Katherine Curi Quinto, Andrew Smyth, Darryl Leong, José Pablo Werba
BACKGROUND: Secondary prevention is cost-effective for cardiovascular disease (CVD), but uptake is suboptimal. Understanding barriers and facilitators to adherence to secondary prevention for CVD at multiple health system levels may inform policy. OBJECTIVES: To conduct a systematic review of barriers and facilitators to adherence/persistence to secondary CVD prevention medications at health system level. METHODS: Included studies reported effects of health system level factors on adherence/persistence to secondary prevention medications for CVD (coronary artery or cerebrovascular disease)...
2016: Open Heart
Naresh Malhotra, M K Keshan, Avinash Agarwal, R Anil Kumar, Abhijit Trailokya, Kalpesh Dalvi, Suhas Talele
BACKGROUND: Cardiovascular diseases (CVD's) are the major cause of morbidity and mortality in both developed and developing countries. Many clinical trials have demonstrated that low-density lipoprotein cholesterol (LDL-C) lowering, reduces the incidence of coronary and cerebrovascular events across a broad spectrum of patients at risk. Guidelines for the management of patients at risk have been established in Europe and North America. The guidelines have advocated progressively lower LDL-C targets and more aggressive use of statin therapy...
April 2016: Journal of the Association of Physicians of India
Karen M Goldstein, Leah L Zullig, Lori A Bastian, Hayden B Bosworth
PURPOSE OF REVIEW: Cardiovascular disease (CVD) continues to be the leading cause of death for men and women in the USA. Statins have contributed significantly to noted declines in cardiovascular-related mortality in the last decade; however, the benefit of statins is inequitable across genders. Women continue to be less likely to take statins and to meet target LDL goals than men. As a possible contributing factor to this disparity, we explore the evidence for gender-based differences in provision of, and adherence to statins...
November 2016: Current Atherosclerosis Reports
Magnus Jörntén-Karlsson, Stéphane Pintat, Michael Molloy-Bland, Staffan Berg, Matti Ahlqvist
Poor adherence to statins increases cardiovascular disease risk. We systematically identified 32 controlled studies that assessed patient-centered interventions designed to improve statin adherence. The limited number of studies and variation in study characteristics precluded strict quality criteria or meta-analysis. Cognitive education or behavioural counselling delivered face-to-face multiple times consistently improved statin adherence compared with control groups (7/8 and 3/3 studies, respectively). None of four studies using medication reminders and/or adherence feedback alone reported significantly improved statin adherence...
October 2016: Drugs
Adina Hayek, Rohina Joshi, Tim Usherwood, Ruth Webster, Baldeep Kaur, Bandana Saini, Carol Armour, Ines Krass, Tracey-Lea Laba, Christopher Reid, Louise Shiel, Charlotte Hespe, Fred Hersch, Stephen Jan, Serigne Lo, David Peiris, Anthony Rodgers, Anushka Patel
BACKGROUND: Cardiovascular diseases (CVD) are responsible for significant morbidity, premature mortality, and economic burden. Despite established evidence that supports the use of preventive medications among patients at high CVD risk, treatment gaps remain. Building on prior evidence and a theoretical framework, a complex intervention has been designed to address these gaps among high-risk, under-treated patients in the Australian primary care setting. This intervention comprises a general practice quality improvement tool incorporating clinical decision support and audit/feedback capabilities; availability of a range of CVD polypills (fixed-dose combinations of two blood pressure lowering agents, a statin ± aspirin) for prescription when appropriate; and access to a pharmacy-based program to support long-term medication adherence and lifestyle modification...
2016: Implementation Science: IS
Julie A Patterson, David A Holdford, Kunai Saxena
OBJECTIVES: To evaluate the cost-benefit of appointment-based medication synchronization (ABMS) offered in community pharmacies for patients taking chronic medications to prevent negative outcomes associated with hyperlipidemia, hypertension, and diabetes. STUDY DESIGN: Decision-tree analysis based on published literature and publicly available data. METHODS: Program benefits were based on linking published findings of improvements in medication adherence due to the implementation of an ABMS program to a claims-based study of disease-related medical costs associated with different levels of adherence...
September 2016: American Journal of Managed Care
Niteesh K Choudhry, Thomas Isaac, Julie C Lauffenburger, Chandrasekar Gopalakrishnan, Nazleen F Khan, Marianne Lee, Amy Vachon, Tanya L Iliadis, Whitney Hollands, Scott Doheny, Sandra Elman, Jacqueline M Kraft, Samrah Naseem, Joshua J Gagne, Cynthia A Jackevicius, Michael A Fischer, Daniel H Solomon, Thomas D Sequist
BACKGROUND: Approximately half of patients with chronic cardiometabolic conditions are nonadherent with their prescribed medications. Interventions to improve adherence have been only modestly effective because they often address single barriers to adherence, intervene at single points in time, or are imprecisely targeted to patients who may not need adherence assistance. OBJECTIVE: To evaluate the effect of a multicomponent, behaviorally tailored pharmacist-based intervention to improve adherence to medications for diabetes, hypertension, and hyperlipidemia...
October 2016: American Heart Journal
Dorairaj Prabhakaran
Among individuals with established CVD, multiple medications (aspirin, blood pressure lowering drugs and statins) are required to manage CVD and it is well established that non adherence to prescribed treatments is substantial in the long term. Such discontinuation of CV-preventive medications and low adherence rates has been shown to affect the success of CVD prevention efforts. In low- and middle income countries only less than 20% patients receive recommended therapy for CVD prevention, but even in high-income countries treatment coverage in the community is only about 50% in those with heart disease and 35% in those with stroke...
September 2016: Journal of Hypertension
N C Tan, C C Goh, S C P Goh, Y L E Koh, K H Koh
WHAT IS KNOWN AND OBJECTIVE: Dyslipidaemia is the key risk factor for arthrosclerosis, leading to myocardial infarctions and strokes. Achieving LDL cholesterol (LDL-C) treatment goals using lipid-lowering therapy (LLT) mitigates such cardiovascular risks. This study aimed to determine the proportions and factors influencing patients with dyslipidaemia on LLT who achieved their recommended LDL-C treatment goals. METHODS: Adult Asian patients with dyslipidaemia, aged 31-80 years, were enrolled in a questionnaire survey...
September 19, 2016: Journal of Clinical Pharmacy and Therapeutics
Bijan J Borah, Yang Qiu, Nilay D Shah, Patrick P Gleason
BACKGROUND: The Medicare 5-Star Rating System measures and provides incentive for improving Medicare Part D plans through a quality-based payment program. Adherence to medications for chronic conditions is key to the Star ratings. Our objective was to assess the impact of direct-to-provider letters on improving medication adherence. METHODS: Members of a large US pharmacy benefits manager (PBM) who did not adhere to prescription of oral diabetes (antidiabetics), cholesterol-reducing (statins), or hypertension (renin angiotensin system [RAS] antagonists) drug therapy were identified from the prescriptions claims data of>600,000 continuously enrolled Medicare members...
September 2016: Healthcare
Marcel J Kooij, Eibert R Heerdink, Liset van Dijk, Erica C G van Geffen, Svetlana V Belitser, Marcel L Bouvy
OBJECTIVES: To assess the effect of a pharmacist telephone counseling intervention on patients' medication adherence. DESIGN: Pragmatic cluster randomized controlled trial. SETTING: 53 Community pharmacies in The Netherlands. PARTICIPANTS: Patients ≥18 years initiating treatment with antidepressants, bisphosphonates, Renin-Angiotensin System (RAS)-inhibitors, or statins (lipid lowering drugs). Pharmacies in arm A provided the intervention for antidepressants and bisphosphonates and usual care for RAS-inhibitors and statins...
2016: Frontiers in Pharmacology
Ashok Reddy, Tiffany L Huseman, Anne Canamucio, Steven C Marcus, David A Asch, Kevin Volpp, Judith A Long
BACKGROUND: Simple nudges such as reminders and feedback reports to either a patient or a partner may facilitate improved medication adherence. OBJECTIVE: To test the impact of a pill bottle used to monitor adherence, deliver a daily alarm, and generate weekly medication adherence feedback reports on statin adherence. DESIGN: Three-month, three-arm randomized clinical trial ( identifier: NCT02480530). PARTICIPANTS: One hundred and twenty-six veterans with known coronary artery disease and poor adherence (medication possession ratio <80 %)...
September 9, 2016: Journal of General Internal Medicine
Erin M Slazak, Jessica T Kozakiewicz, Natalie S Winters, Jason R Smith, Scott V Monte
BACKGROUND: Medication nonadherence contributes to approximately US$290 billion per year in avoidable health-care spending. Statins are of particular interest because of their importance to patient outcomes, costs of treatment failure, and categorization as a Medicare star measure linked to financial reimbursement. OBJECTIVE: To evaluate statin adherence as defined by the proportion of days covered (PDC) among patients who use an embedded dispensing pharmacy in a patient-centered medical home (PCMH)...
September 6, 2016: Journal of Pharmacy Practice
Gretchen Benson, Dawn R Witt, Jeffrey J VanWormer, Susan M Campbell, Arthur Sillah, Sharonne N Hayes, Matt Lui, Martha Gulati
BACKGROUND: Hypercholesterolemia is a major risk factor for cardiovascular disease. Women with hypercholesterolemia and familial hypercholesterolemia (FH) are a high-risk group often underdiagnosed, undertreated, and unaware of the need for cascade screening. OBJECTIVES: The objectives were to identify the prevalence of hypercholesterolemia and FH in 2 national databases, explore lifestyle/medication adherence, and examine rates of cascade screening (lipid testing in all first-degree relatives) among those with FH...
July 2016: Journal of Clinical Lipidology
Nina R Joyce, Gregory A Wellenius, Charles B Eaton, Amal N Trivedi, Justin P Zachariah
BACKGROUND: The American Academy of Pediatrics recommends lipid-lowering therapy (LLT) for children at high risk of cardiovascular disease. However, the use of LLT in children is rare, and rates of nonadherence are unknown. OBJECTIVE: To identify patterns of use and predictors of nonadherence to LLT in children aged 8 to 20 years and the subgroup with dyslipidemia. METHODS: Commercially insured patients with a new dispensing for an LLT were included...
July 2016: Journal of Clinical Lipidology
Bruce C Stuart, Xian Shen, Charlene C Quinn, Nicole Brandt, Pamela Roberto, F Ellen Loh, Franklin Hendrick, Caroline Kim, Xingyue Huang, Swapnil Rajpathak
BACKGROUND: Noninsulin antihyperglycemic agents (NAAs) are the mainstay of treatment for type 2 diabetes, yet persistence in NAA use is suboptimal in many diabetes patients. Most of the research on NAA discontinuance has focused on sociodemographic characteristics and general health status, but such factors are inherently limited in explaining dynamic events such as discontinuance. OBJECTIVE: To assess the relative importance of static and proximal dynamic factors in explaining long-term NAA discontinuance among Medicare beneficiaries with diabetes...
September 2016: Journal of Managed Care & Specialty Pharmacy
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