The American journal of managed care
-
This study assessed the impact of transition from Medicaid drug coverage to Medicare Part D on a sample of dually eligible adults younger than age 65 years with disabilities. ⋯ The high incidence of access problems despite Centers for Medicare & Medicaid Services (CMS) safeguards points to the need for ongoing monitoring of Part D. If the problems persist, CMS must be willing to modify the program and/or better enforce the rules already in place to avoid adverse outcomes for beneficiaries with disabilities.
-
To evaluate a program to reduce musculoskeletal disability-related absenteeism at a North American manufacturing facility. ⋯ This intervention was associated with reduced musculoskeletal disability-related absenteeism and increased productivity. The program reduced medical costs per work-related injury and improved the company's communications and relationship with local physicians.
-
Coronary heart disease (CHD) remains the leading cause of mortality in the United States, and factors such as age, gender, or race/ethnicity have a significant impact on cardiovascular risk. More than 80% of people who die from CHD are 65 years or older. Because women experience myocardial infarction (MI) at older ages than men, their mortality from MI is greater than it is for men. ⋯ Given this information, aggressive treatment of CHD risk factors is critical in black individuals, older individuals, and women. Although abundant randomized, controlled clinical data exist to support the efficacy of lipid-lowering therapy in preventing CHD events, these populations have traditionally been underrepresented in intervention-based clinical trials, despite their high prevalence of CHD. This article will explore the evidence for instituting statin therapy as part of a risk reducing strategy in older individuals, women, and ethnic minorities.
-
To determine whether low-income seniors and those without prescription drug coverage are more likely to use generic cardiovascular drugs than more affluent and better insured adults. ⋯ Seniors with low incomes or no prescription coverage were only somewhat more likely to use generic cardiovascular drugs than more affluent and insured seniors. These findings suggest that physicians and policy makers may be missing opportunities to reduce costs for Medicare and its economically disadvantaged beneficiaries.
-
Randomized Controlled Trial
Evaluation of laboratory monitoring alerts within a computerized physician order entry system for medication orders.
Errors involving medication use are common. Computerized physician order entry (CPOE) can improve prescribing practices. Few studies have examined the effect of CPOE in combination with decision support tools on prescribing practices in the outpatient setting. Less is known about prescribers' adherence to laboratory monitoring recommendations. ⋯ As CPOE becomes more prevalent, additional research is needed to determine effective decision support tools. These findings then should be communicated to the developers and users of computerized medical record systems.