The American journal of managed care
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To determine the use of formulary restrictions (prior authorization and step therapy) on the use of non-vitamin K antagonist oral anticoagulants (NOACs) and their effect on health outcomes. ⋯ Limiting access to NOACs may exacerbate current underuse of anticoagulants and increase the risk of stroke among patients with newly diagnosed AF. Pharmacy benefit managers and Part D plans need to continuously review the appropriateness of formulary policies to ensure patient access to effective medications.
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To improve diabetic retinopathy (DR) screening rates through a primary care-based "teleretina" screening program incorporating clinical informatics tools. ⋯ New models of health care delivery, including telemedicine workflows, have become increasingly important for complex diabetic care coordination and require substantial health IT engagement. This program illustrates how clinical informatics tools can make substantial contributions to improving diabetes care.
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After the release of the CDC guidelines in March 2016, the rate of opioid prescriptions decreased. How or whether pharmaceutical companies changed their opioid marketing practices post release of the CDC guidelines is unknown. Our objectives were to (1) evaluate whether the release of the guidelines was associated with changes in total monthly marketing spending received per physician, monthly marketing encounter frequency per physician, and spending per encounter during opioid marketing; and (2) evaluate whether such changes in marketing differed between specialist physicians and primary care physicians (PCPs) and between urban and rural primary care service areas (PCSAs). ⋯ It is important to continue ongoing education for physicians on changes in pharmaceutical opioid marketing practices.
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The authors interrogate elements of routine medical practice in New York City to argue for reforms of hospital culture through relational trust-building capabilities of community health workers.
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Observational Study
Implementation and cost validation of a real-time benefit tool.
To assess the accuracy of a real-time benefit tool (RTBT) that is compliant with the standards of the National Council for Prescription Drug Programs (NCPDP) in a large academic medical center. ⋯ Current standards established by NCPDP yield accurate patient out-of-pocket estimates and could serve as a national standard for all Part D sponsors.