Health care system-level factors associated with performance on medicare STAR adherence metrics in a large, integrated delivery system

Medical Care

Volumn 53, Issue 4, 2015, Pages 332-337

  Schmittdiel, Julie A ^a   Nichols, Gregory A ^b   Dyer, Wendy ^a   Steiner, John F ^c   Karter, Andrew J ^a   Raebel, Marsha A ^c  

^a DIVISION OF RESEARCH   (United States)

^b CENTER FOR HEALTH RESEARCH   (United States)

^c Kaiser Permanente Colorado   (United States)

Author keywords

adherence; quality improvement; quality measurement

Indexed keywords

ANTIDIABETIC AGENT; ANTIHYPERTENSIVE AGENT; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR;

AGED; ANTIHYPERTENSIVE THERAPY; ARTICLE; CARDIOVASCULAR RISK; CONTROLLED STUDY; CROSS-SECTIONAL STUDY; DIABETIC PATIENT; ELECTRONIC MEDICAL RECORD; FEMALE; HEALTH CARE DELIVERY; HEALTH CARE SYSTEM; HUMAN; ICD-9; MAJOR CLINICAL STUDY; MALE; MEDICARE; MEDICATION COMPLIANCE; PHARMACY; PRIORITY JOURNAL; VERY ELDERLY; COST; DIABETES MELLITUS; DRUG UTILIZATION; INSURANCE; POSTAL MAIL; SOCIOECONOMICS; STATISTICS AND NUMERICAL DATA; UNITED STATES;

AGED; AGED, 80 AND OVER; ANTIHYPERTENSIVE AGENTS; COST SHARING; CROSS-SECTIONAL STUDIES; DIABETES MELLITUS; DRUG UTILIZATION; FEMALE; HUMANS; HYDROXYMETHYLGLUTARYL-COA REDUCTASE INHIBITORS; HYPOGLYCEMIC AGENTS; INSURANCE CLAIM REVIEW; MALE; MEDICARE; MEDICATION ADHERENCE; POSTAL SERVICE; SOCIOECONOMIC FACTORS; UNITED STATES;

EID: 84925933889     PISSN: 00257079     EISSN: 15371948     Source Type: Journal    
DOI: 10.1097/MLR.0000000000000328     Document Type: Article

References (36)

1. Kaiser Family Foundation. Reaching for the Stars: Quality Ratings of Medicare Advantage Plans, 2011. Issue Brief. Available at: http://www.kff.org/medicare/upload/8151.pdf. Accessed October 2, 2012
2. Steiner JF. Rethinking adherence. Ann Intern Med. 2012; 157: 580-585
3. Schmittdiel J, Raebel M, Dyer W, et al. The Medicare STAR adherence measure excludes diabetes patients with poor CVD risk factor control. Am J Manag Care. 2015; 20: e581-e589
4. Wienbergen H, Senges J, Gitt AK. Should we prescribe statin and aspirin for every diabetic patient? Is it time for a polypill? Diabetes Care. 2008; 31(suppl 2): S222-S225
5. Johnson ML, Singh H. Patterns of antihypertensive therapy among patients with diabetes. J Gen Intern Med. 2005; 20: 842-846
6. Konzem SL, Devore VS, Bauer DW. Controlling hypertension in patients with diabetes. Am Fam Physician. 2002; 66: 1209-1214
7. Schmittdiel JA, Uratsu CS, Karter AJ, et al. Why don't diabetes patients achieve recommended risk factor targets? Poor adherence versus lack of treatment intensification. J Gen Intern Med. 2008; 23: 588-594
8. Schmittdiel JA, Uratsu CS, Fireman BH, et al. The effectiveness of diabetes care management in managed care. Am J Manag Care. 2009; 15: 295-301
9. Ho PM, Rumsfeld JS, Masoudi FA, et al. Effect of medication nonadherence on hospitalization and mortality among patients with diabetes mellitus. Arch Intern Med. 2006; 166: 1836-1841
10. Wiegand P, McCombs JS, Wang JJ. Factors of hyperlipidemia medication adherence in a nationwide health plan. Am J Manag Care. 2012; 18: 193-199
11. Walker EA, Molitch M, Kramer MK, et al. Adherence to preventive medications: predictors and outcomes in the Diabetes Prevention Program. Diabetes Care. 2006; 29: 1997-2002
12. Yang Y, Thumula V, Pace PF, et al. Predictors of medication nonadherence among patients with diabetes in Medicare Part D programs: a retrospective cohort study. Clin Ther. 2009; 31: 2178-2188; discussion 2150-2171
13. Raebel MA, Ellis JL, Carroll NM, et al. Characteristics of patients with primary non-Adherence to medications for hypertension, diabetes, and lipid disorders. J Gen Intern Med. 2012; 27: 57-64
14. Duru OK, Schmittdiel JA, Dyer WT, et al. Mail-order pharmacy use and adherence to diabetes-related medications. Am J Manag Care. 2010; 16: 33-40
15. Schmittdiel JA, Karter AJ, Dyer W, et al. The comparative effectiveness of mail order pharmacy use vs. local pharmacy use on LDL-C control in new statin users. J Gen Intern Med. 2011; 26: 1396-1402
16. Adams AS, Uratsu C, Dyer W, et al. Health system factors and antihypertensive adherence in a racially and ethnically diverse cohort of new users. JAMA Intern Med. 2013; 173: 54-61
17. Nichols GA, Desai J, Elston Lafata J, et al. Construction of a multisite DataLink using electronic health records for the identification, surveillance, prevention, and management of diabetes mellitus: the SUPREME-DM project. Prev Chronic Dis. 2012; 9: E110
18. Raebel MA, Xu S, Goodrich GK, et al. Initial antihyperglycemic drug therapy among 241 327 adults with newly identified diabetes from 2005 through 2010: a surveillance, prevention, and management of diabetes mellitus (SUPREME-DM) study. Ann Pharmacother. 2013; 47: 1280-1291
19. Schmittdiel J, Raebel M, Dyer W, et al. Prescription medication burden in patients with newly-diagnosed diabetes: the SUrveillance, PREvention, and ManagEment of Diabetes Mellitus (SUPREME-DM) cohort. J Am Pharm Assoc. 2014; 54: 374-382
20. Raebel MA, Ellis JL, Schroeder EB, et al. Intensification of antihyperglycemic therapy among patients with incident diabetes: a Surveillance Prevention and Management of Diabetes Mellitus (SUPREME-DM) study. Pharmacoepidemiol Drug Saf. 2014; 23: 609-618
21. Miller DR, Safford MM, Pogach LM. Who has diabetes? Best estimates of diabetes prevalence in the Department of Veterans Affairs based on computerized patient data. Diabetes Care. 2004; 27(suppl 2): B10-B21
22. O'Connor PJ, Rush WA, Pronk NP, et al. Identifying diabetes mellitus or heart disease among health maintenance organization members: sensitivity, specificity, predictive value, and cost of survey and database methods. Am J Manag Care. 1998; 4: 335-342
23. Zgibor JC, Orchard TJ, Saul M, et al. Developing and validating a diabetes database in a large health system. Diabetes Res Clin Pract. 2007; 75: 313-319
24. Medicare Health and Drug Plan Quality and Performance Ratings, 2013 Part C and Part D Technical Notes-First Plan Preview-Draft. CMS website. Available at: http://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn/Downloads/Technical-Notes-2013-.pdf. Updated August 9, 2012
25. Pharmacy Quality Alliance. Proportion of Days Covered (PDC) as a preferred method of measuring medication adherence. Available at: http://www.pqaalliance.org/images/uploads/files/PQA%20PDC%20vs%20%20MPR.pdf. Accessed January 16, 2015
26. Zou G. A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004; 159: 702-706
27. Cameron AC, Trivedi PK. Microeconometrics Using Stata, Revised Edition. College Station, TX: STATA Press; 2010
28. Shrank WH, Stedman M, Ettner SL, et al. Patient, physician, pharmacy, and pharmacy benefit design factors related to generic medication use. J Gen Intern Med. 2007; 22: 1298-1304
29. Steiner JF, Robbins LJ, Roth SC, et al. The effect of prescription size on acquisition of maintenance medications. J Gen Intern Med. 1993; 8: 306-310
30. Batal HA, Krantz MJ, Dale RA, et al. Impact of prescription size on statin adherence and cholesterol levels. BMC Health Serv Res. 2007; 7: 175
31. Foster DG, Hulett D, Bradsberry M, et al. Number of oral contraceptive pill packages dispensed and subsequent unintended pregnancies. Obstet Gynecol. 2011; 117: 566-572
32. Schmittdiel JA, Ettner SL, Fung V, et al. Medicare Part D coverage gap and diabetes beneficiaries. Am J Manag Care. 2009; 15: 189-193
33. Choudhry NK, Avorn J, Glynn RJ, et al. Full coverage for preventive medications after myocardial infarction. N Engl J Med. 2011; 365: 2088-2097
34. Choudhry NK, Fischer MA, Smith BF, et al. Five features of valuebased insurance design plans were associated with higher rates of medication adherence. Health Aff (Millwood). 2014; 33: 493-501
35. Duru OK, Gerzoff RB, Selby JV, et al. Identifying risk factors for racial disparities in diabetes outcomes: the translating research into action for diabetes study. Med Care. 2009; 47: 700-706
36. Thaler RH, Sunstein CR. Nudge: Improving Decisions About Health, Wealth, and Happiness. New Haven, CT: Yale University Press; 2008