The American journal of managed care
-
Randomized Controlled Trial
Evaluation of a packaging approach to improve cholesterol medication adherence.
Elevated low-density lipoprotein cholesterol (LDL-C) is a major modifiable risk factor for cardiovascular disease, a leading cause of death in the United States. Our goal was to evaluate a simple, scalable, and affordable medication packaging method for improving cholesterol medication adherence and subsequently lowering LDL-C levels. ⋯ In a sample of US veterans, prefilled calendared blister packaging provided an inexpensive method for improving cholesterol medication adherence.
-
Randomized Controlled Trial
Treatment barriers among younger and older socioeconomically disadvantaged smokers.
Underutilization of smoking cessation treatments contributes to high rates of smoking in socioeconomically disadvantaged populations. Guided by a conceptual framework, the present study explored how healthcare provider factors, social environment characteristics, and cessation beliefs influence treatment utilization among low-income smokers and whether these associations vary by age. ⋯ In this sample of low-income smokers, interest in quitting was high but treatment utilization was low. Increasing utilization of cessation treatments via interventions that target issues specific to low-income smokers, including healthcare provider access and advice, the home environment, and motivation to quit, is an important step toward reducing smoking rates in this population.
-
To assess whether Medicare formularies restrict access to drugs receiving new FDA black box warnings for which safer drug alternatives are available. ⋯ Medicare formularies became more restrictive for half of the drugs that recently received new FDA black box warnings for death and/or cardiovascular risk and for which safer drug alternatives are available. However, a substantial proportion of formularies remained unrestrictive, suggesting inconsistent responses to new safety information to curtail the use of these medications.
-
To examine temporal trends and racial/ethnic differences in hip fracture incidence and mortality outcome in older men. ⋯ Although hip fracture rates were largely stable among older men, contemporary rates of hip fracture were highest for white and lowest for Asian men. One-year mortality was similar for white, black, and Hispanic men, but significantly lower for Asians. Future studies should investigate factors underlying observed ethnic differences in fracture outcome among US men.
-
To estimate the effects of selecting a narrow provider network on outpatient utilization and outpatient out-of-pocket (OOP) expenditures among individuals who chose to enroll in a narrow network plan in 2014. ⋯ Our findings suggest that individuals who selected narrow network plans in 2014 were able to keep costs low without changing their overall number of outpatient visits. Narrow network plans can reduce costs to beneficiaries without affecting the volume of outpatient visits, if appropriate incentives to visit participating providers are followed.