Decreased Cost-Sharing Increased Patient Adherence

MedicalResearch.com Interview with:

A. Mark Fendrick, M.D. Professor, Division of General Medicine, Department of Internal Medicine and Department of Health Management and Policy Director, University of Michigan Center for Value-Based Insurance Design Ann Arbor, Michigan 48109-2800

Dr. Fendrick

A. Mark Fendrick, M.D.
Professor, Division of General Medicine, Department of Internal Medicine and Department of Health Management and Policy
Director, University of Michigan Center for Value-Based Insurance Design
Ann Arbor, Michigan 48109-2800

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: As Americans are being asked to pay more for the medical care, in terms of copayments and deductibles, one in four Americans reports having difficulty paying for their prescription drugs. One potential solution is “value-based insurance design,” or V-BID. V-BID, is built on the principle of lowering or removing financial barriers to essential, high-value clinical services. V-BID plans align patients’ out-of-pocket costs, such as copayments and deductibles, with the value of services to the patient. They are designed with the tenet of “clinical nuance” in mind— in that the clinical benefit derived from a specific service depends on the consumer using it, as well as when, where, and by whom the service is provided.

According to a literature review published in the July 2018 issue of Health Affairs,  The researchers found that value-based insurance design programs which reduced consumer cost-sharing for clinically indicated medications resulted in increased adherence at no change in total spending. In other words, decreasing consumer cost-sharing meant better medication adherence for the same total cost to the insurer. Continue reading

Medication Adherence Rates Vary Widely Across US Hospitals

Dr. Tracy Wang Assistant Dean, Continuing Medical Education Director, Center for Educational Excellence Fellowship Associate Program Director Associate Professor of Medicine, Cardiology Duke Clinical Research Institut

Dr. Tracy Wang

MedicalResearch.com Interview with:
Dr. Tracy Wang MD MHS MSc
Assistant Dean, Continuing Medical Education
Director, Center for Educational Excellence
Fellowship Associate Program Director
Associate Professor of Medicine, Cardiology
Duke Clinical Research Institute

Medical Research: What is the background for this study? What are the main findings?

Response: Medication non-adherence is a known challenge in the management of patients with coronary artery disease. Barriers to adherence are multifactorial, attributed to patient, healthcare provider, and social determinants. However, whether patient medication adherence varies across different hospitals is unknown. In this study, we sought to determine whether inter-hospital differences exist in the degree of patient adherence to secondary prevention medications after discharge. Moreover, we assessed whether these hospital-specific variations in medication adherence, if any, correspond to downstream patient outcomes.

We observed that the majority of post-MI patients were prescribed guideline-recommended secondary prevention medications at discharge. However, among those prescribed, we see a significant decline in the use of these medications within just 90 days after discharge. Medication adherence rates varied markedly across U.S. hospitals, with the widest variation seen for post-discharge use of beta-blockers. Hospitals with high post-discharge  medication adherence were associated with significantly lower risk of major adverse cardiovascular events and death or all-cause readmissions when compared with hospitals with low adherence rates, even after adjustment for differences in patient case-mix.

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Smart Phone Technology May Improve Medication Adherence

MedicalResearch.com Interview with:
Dr. Frederick Kaskel: MD PhD Chief, Division of Pediatric Nephrology, Department of Pediatrics Albert Einstein College of Medicine
Dr. Frederick Kaskel: MD PhD

Chief, Division of Pediatric Nephrology, Department of Pediatrics
Albert Einstein College of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Frederick Kaskel: Non-adherence to medication and medical regimens is a serious and common problem in adolescents with various kidney disorders, resulting in increasing morbidity and mortality. Innovative efforts to engage this at risk population to prevent or lessen the cycle of non-adherence are needed.

Employing new smart phone technology has resulted in changes in this targeted population’s awareness of their conditions and need to be adherent to the medical regimen.

Texting reminders regarding medication alerts may result in a better participation of the adolescent in his/her health care governance. Long-term studies are needed in order to assess outcomes.

Citation:

2014 ASN abstract:

Utilization of Smart Phones and Medication Adherence in Adolescents with Kidney Disorders
 

Resistant Hypertension: Better Control With Therapeutic Drug Monitoring

Dr. Wanpen Vongpatanasin, MD Professor of Medicine Director, Hypertension Section Cardiology Division UT Southwestern Medical CenteMedicalResearch.com Interview with;
Dr. Wanpen Vongpatanasin, MD
Professor of Medicine
Director, Hypertension Section, Cardiology Division
UT Southwestern Medical Center


MedicalResearch.com: What are the main findings of the study?

Dr. Vongpatanasin: We found that more than 50% of patients with resistant hypertension were non-adherent to at least one drug prescribed by their primary care physicians for blood pressure control.

When we provided this information back to the patients, as part of care in our hypertension specialty clinic, we found that many patients report difficulty taking prescribed medications due to either associated side effects or cost of the medication. When we adjusted patient’s medications to fit their needs, BP levels were substantially improved during subsequent visits without increasing the number of medications.
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SLE: Poor Medication Adherence

Dr. Jinoos Yazdany MD, MPH Assistant Professor in Residence UCSF School of MedicineMedicalResearch.com Interview with:
Dr. Jinoos Yazdany MD, MPH
Assistant Professor in Residence
UCSF School of Medicine


MedicalResearch.com: What are the main findings of the study?

Answer: For almost all of the drugs we examined, we found that less than half of patients adhered to treatment.  For some drugs, less than one-third of individuals were adherent. The average medication possession ratios were low across all drugs.

We found that several factors played an important part in adherence.  Younger individuals were less likely to adhere to treatment for several drugs, and we also found racial/ethnic differences, with Black, Hispanic and Native populations having lower adherence.  We also found geographic variation in adherence, with individuals in the Northeast being the most likely to adhere to treatment.

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Antipsychotics: Financial Incentives to Improve Medication Adherence

Professor Stefan Priebe, Dipl.-Psych., Dr. med. habil., FRCPsych Unit for Social and Community Psychiatry WHO Collaborating Centre for Mental Health Services Development Queen Mary, University of LondonMedicalResearch.com Interview with
Professor Stefan Priebe, Dipl.-Psych., Dr. med. habil., FRCPsych
Unit for Social and Community Psychiatry
WHO Collaborating Centre for Mental Health Services Development
Queen Mary, University of London

MedicalResearch.com: What are the main findings of the study?

Answer: Offering modest financial incentives can help patients to achieve better adherence to anti-psychotic maintenance medication.  Continue reading