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1.
Sr Care Pharm ; 35(2): 85-92, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-32019643

RESUMO

OBJECTIVE: To identify characteristics in an ambulatory Medicare population that are significantly more likely to be associated with a high risk of undiagnosed prediabetes.
DESIGN: Cross-sectional study.
SETTING: Fourteen health clinics targeting Medicare beneficiaries were held throughout northern and central California during the fall of 2017.
PATIENTS, PARTICIPANTS: Noninstitutionalized Medicare beneficiaries receiving medication therapy management services without self-reported diabetes.
INTERVENTIONS: Beneficiaries were screened for their risk of type 2 diabetes mellitus (T2DM) through the use of the American Diabetes Association (ADA) risk assessment (score of ≥ 5 indicates increased risk of developing type 2 diabetes) by pharmacy students. For this study, patients with a score of ≥ 5 were considered to be at high risk for undiagnosed prediabetes.
MAIN OUTCOME MEASURE(S): Characteristics significantly more likely to be identified in patients at high risk for undiagnosed prediabetes.
RESULTS: A total of 683 Medicare beneficiaries without self-reported diabetes completed the ADA risk assessment, with 457 (66.9%) receiving a score of 5 or more. In those, the presence of hyperlipidemia, hypertension, obesity, coronary heart disease, and use of aspirin were all characteristics researchers identified as significantly more likely to be found in this group. In contrast, those of Asian race or who took dietary supplements were significantly less likely to score 5 or higher in the questionnaire.
CONCLUSION: Identification of older adults at higher risk for undiagnosed prediabetes through the use of appropriate screening tools allows for targeted preventive interventions, potentially lowering risk of developing T2DM for selected patients.


Assuntos
Estado Pré-Diabético , Idoso , California , Estudos Transversais , Diabetes Mellitus Tipo 2 , Humanos , Vida Independente , Medicare , Estados Unidos
2.
Res Social Adm Pharm ; 16(6): 783-786, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31447267

RESUMO

BACKGROUND: Medication-related problems (MRPs) are a major healthcare burden. The rate of MRPs in those ≥65 years old is ∼50 events per 1000 person-years, and contributes to a four-fold higher hospitalization rate when compared to younger patients. Medication therapy management (MTM) can identify MRPs in high-risk patients. However, in 2015, only 12.9% of Medicare patients qualified for MTM services through their Part D plan. OBJECTIVE: To examine the type and frequency of MRPs in community-dwelling Medicare beneficiaries and which patient factors are associated with having ≥1 MRP. METHODS: Fourteen health clinics targeting Medicare beneficiaries were held in 10 Northern/Central California cities during Fall 2017. Trained student pharmacists, supervised by licensed pharmacists, conducted comprehensive medication reviews. Sociodemographic, chronic condition, medication, and MRP data were collected via standardized surveys. RESULTS: MTM services were provided to 910 patients, of which 633 (69.6%) had at least 1 MRP. The most common MRPs were severe drug-drug interaction [n = 297(33.4%)] and untreated condition [n = 134 (14.7%). Individuals with MRPs took significantly more prescription and over-the-counter medications. Additionally, those with MRPs were more likely to be subsidy recipients and in a Medicare Advantage Prescription Drug Plan. A total of 120 (13%) individuals were found to have had an MRP severe enough to warrant prescriber follow-up. CONCLUSIONS: Although only a fraction of Medicare beneficiaries qualify for MTM services through their Part D plan, many can benefit from such services. Understanding the type, frequency, and factors contributing to MRPs is imperative to identify and avoid negative sequelae. Reduction of MRPs can potentially improve patient clinical outcomes, increase quality-of-life, and decrease overall cost of care.


Assuntos
Medicare Part D , Medicamentos sob Prescrição , Idoso , Humanos , Conduta do Tratamento Medicamentoso , Farmacêuticos , Estudos Retrospectivos , Estados Unidos
3.
Intellect Dev Disabil ; 57(3): 234-241, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31120407

RESUMO

Nonelderly disabled Medicare beneficiaries have a higher prevalence of chronic conditions, higher utilization of prescription medications, and increased demand for clinical services when compared to beneficiaries 65 years of age and older who are not disabled. Out-of-pocket costs and medication-related problems are major barriers to medication compliance and achievement of therapeutic goals. A school of pharmacy partnered with a nonprofit organization that provides care to individuals with developmental disabilities. The present study highlights outcomes resulting from (a) providing Medicare Part D plan optimization services to lower prescription drug costs and (b) Medication Therapy Management services to evaluate safe and effective medication use in this beneficiary population. Provided interventions were shown to reduce overall medication costs and identify significant medication-related problems.


Assuntos
Deficiências do Desenvolvimento/economia , Gastos em Saúde , Medicare Part D/economia , Medicamentos sob Prescrição/economia , Adulto , Idoso , Redução de Custos , Deficiências do Desenvolvimento/tratamento farmacológico , Custos de Medicamentos , Feminino , Humanos , Benefícios do Seguro/economia , Masculino , Conduta do Tratamento Medicamentoso/economia , Pessoa de Meia-Idade , Projetos Piloto , Estados Unidos
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