The American journal of managed care
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Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease of unknown etiology characterized by fibrosis of the interstitium, resulting in progressive respiratory insufficiency and shortened lifespan. Treatment focus tends to shift from disease-centered to symptom-centered as the disease progresses. Over the years, a number of pharmacologic strategies have been used to treat IPF, albeit without solid evidence demonstrating a beneficial impact on the disease course. ⋯ The treatment landscape changed in October 2014, when the FDA approved pirfenidone and nintedanib for the treatment of IPF. For the first time, clinicians have therapeutic options with demonstrated clinical efficacy to treat patients with IPF. To provide effective high-value care for patients with IPF, healthcare professionals require thorough knowledge and awareness about these medications, including their safety concerns.
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Observational Study
Socioeconomic disparities across ethnicities: an application to cervical cancer screening.
Our aim is to investigate socioeconomic disparities in cervical cancer screening utilization among and between ethnic groups in the United States. ⋯ Uptake of cervical cancer screening is common in the United States, with large socioeconomic disparities also evident. Those from lower socioeconomic or uninsured groups who are most likely to have, and to die from, cervical cancer, are least likely to use preventive screening. Disparities differ across ethnic groups and are greatest amongst white women. Incorporating organized screening may serve to improve both the systems efficiency and address disparities between and within groups.
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Observational Study
Targeting a high-risk group for fall prevention: strategies for health plans.
Although Medicare has implemented incentives for health plans to reduce fall risk, the best way to identify older people at high risk of falling and to use screening results to target fall prevention services remains unknown. We evaluated 4 different strategies using a combination of administrative data and patient-reported information that health plans could easily obtain. ⋯ The combination of administrative data and a simple screening item can be used by health plans to target patients at high risk for future fall-related injuries.
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To evaluate the ability of initial medication dispensings to predict long-term patterns of adherence. ⋯ Initial filling behavior strongly predicted future adherence trajectory. Predicting adherence trajectories may facilitate better targeting of interventions to patients most likely to benefit.