Group-Based Trajectory Models to Evaluate the Association of Lipid Testing and Statin Adherence.

Background And Objective: Performing lipid testing after statin initiation is recommended to monitor response. Inadequate response may indicate non-adherence, which is associated with an increased risk of cardiovascular events and increased costs. Group-based trajectory modeling is an approach to establish probabilistic developmental trajectories of adherence, differentiating individuals by their distinct longitudinal medication-taking behaviors.

Older adult and caregiver needs for patient-centered outcomes research training in medication optimization.

Background: Improved health outcomes and lower costs have been reported with pharmacist-led patient-centered approaches to medication optimization in older adults, but heterogeneity in studies has complicated assessments of how well these approaches have worked. Among the challenges in advancing care from patient-centered research is uncertainty in how well research questions have matched patients' care needs. One strategy is to engage patients, ideally as equal partners, in the preparation, execution, and dissemination of research.

Applying the Andersen behavioral model to the medication therapy management program: an approach for improving medication safety in older adults.

Medication therapy problems (MTPs) are common among older adults and are associated with considerable morbidity, mortality, and healthcare costs. The Medicare Part D Medication Therapy Management (MTM) program, which includes Comprehensive Medication Reviews (CMRs), Targeted Medication Reviews (TMRs), and guidance on safe medication disposal, is designed to optimize therapeutic outcomes and reduce adverse events by addressing MTPs. Although this program has demonstrated success in reducing MTPs, its utilization remains low, with ongoing concerns about service access disparities, patient satisfaction, and long-term health outcomes.

Co-designing Medication Optimization Patient-Centered Outcomes Research With Older People and Caregivers as Research Partners.

Additional evidence is required to address the unintended consequences of medication use in older people and the required caregiver support. To inform priorities for future research efforts, different stakeholder perspectives are needed, including those of older people, caregivers, clinicians, and researchers. To develop a co-designed medication-related research agenda.

Initial non-adherence to lipid-lowering medication: a systematic literature review.

Background: The impact on cardiovascular health is lost when a patient does not obtain a newly prescribed lipid-lowering medication, a situation termed "initial medication nonadherence" (IMN). This research summarizes the published evidence on the prevalence, associated factors, consequences, and solutions for IMN to prescribed lipid-lowering medication in the United States.

Methods: A systematic literature search using PubMed and Google Scholar, along with screening citations of systematic reviews, identified articles published from 2010 to 2021.

Costs and health care resource utilization among Medicare beneficiaries diagnosed with chronic lymphocytic leukemia.

Background: Chronic lymphocytic leukemia (CLL) is the most common type of leukemia. However, published studies of CLL have either only focused on costs among individuals diagnosed with CLL without a non-CLL comparator group or focused on costs associated with specific CLL treatments. An examination of utilization and costs across different care settings provides a holistic view of utilization associated with CLL.

Disparity in treatment patterns among Medicare beneficiaries diagnosed with chronic lymphocytic leukemia: an analysis of patient and contextual factors.

This study characterizes the patterns and timing of CLL treatment and, to our knowledge, is the first to identify social vulnerability factors associated with CLL treatment receipt in the Medicare population. A total of 3508 Medicare beneficiaries diagnosed with CLL from 2017 to 2019 were identified. We reported the proportion of individuals who received CLL treatment and the time until the first CLL treatment receipt after the first observed claim with a CLL diagnosis.

Assessing suboxone access in community pharmacies: Secret shopper model.

Objective: To assess whether Maryland community pharmacies had Suboxone available for dispensing.

Methods: This cross-sectional study used a secret shopper model to contact public-facing community pharmacies in Maryland. The secret shopper, guided by a script, asked whether a prescription for Suboxone was available for the same or next day pick-up.

Efficacy of a Flavored Lubricating Oral Spray on Medication Swallowing in Older Individuals.

Difficulty swallowing occurs in up to 35% of patients 50 years of age or older and can contribute to medication nonadherence and other alterations. The use of a flavored lubricating spray, available over-the-counter and found to be helpful in children to swallow oral solid medications, is not well studied in older adults. To evaluate the effect of a flavored lubricating spray on the ability to swallow oral solid medication in older people.

Social determinants predict whether Medicare beneficiaries are offered a Comprehensive Medication Review.

Background: Medication reviews through Medicare's Medication Therapy Management (MTM) program may improve patient outcomes and lower health system costs, but these effects could be limited by a program design that does not address social determinants of health.

Objective: To analyze the effects of social determinants of health on the odds of an eligible Medicare beneficiary not being offered Comprehensive Medication Review (CMR).

Methods: Using the full 100% sample of the 2016 Part D Medication Therapy Management Data File linked to Medicare Master Beneficiary Summary File, a retrospective, cross-sectional analysis was conducted to determine which social and demographic variables are most strongly associated with being eligible for a CMR but not being offered one.

Evolution of the Comprehensive Medication Review Completion Rate for Medicare Part D Plans: What Do the Stars Tell Us?

To describe changes in the Medicare Part D Comprehensive Medication Review (CMR) completion rate within the Centers for Medicare & Medicaid Services (CMS) Star Ratings program since its inception. Publicly available information for Star Ratings years 2014 to 2021 was obtained from the CMS website and through indexed literature and internet searches. Data elements for the CMR completion measure were extracted for Medicare Advantage prescription drug plans (MA-PDs) and prescription drug plans (PDPs) and included the annual weighted value, cut-points for star rating, completion rates, and star achievement.

Opioid prescribing patterns in a commercially insured population.

Background: Claims data evaluations have advanced our understanding about patient risk factors and predictors for opioid misuse and aid in patient identification. However, less evidence is available to guide the identification of prescribers with at-risk prescribing practices. Thus, an algorithm was developed to identify prescribers with outlying patterns of opioid prescriptions in a managed care organization.

Implementation of academic detailing for pharmacists on opioid use disorder and harm reduction.

Background: The United States is experiencing an opioid crisis, substantially worsened by the pandemic. Pharmacists play a critical role in expanding access to care through harm reduction efforts and medications to treat opioid use disorder (mOUD), yet lack necessary education and resources. Academic detailing is a one-on-one technique, which can effectively address educational gaps.

Initial non-adherence to antihypertensive medications in the United States: a systematic literature review.

An important component of hypertension management is the initiation and continuation of antihypertensive medications. Non-adherence during the long-term use of antihypertensive medications is well studied. However, there is a paucity of research about the frequency and clinical consequences of failing to take the first dose of an antihypertensive, a treatment challenge known as initial medication non-adherence (IMN).

Understanding the Socioeconomic and Geographical Characteristics of Beneficiaries Receiving a Comprehensive Medication Review.

Background: Medicare Part D sponsors are required to offer medication therapy management (MTM) programs to eligible beneficiaries. Recent studies have demonstrated that there have been racial/ethnic disparities in MTM eligibility criteria. For example, compared with non-Hispanic White beneficiaries, Hispanic and non-Hispanic Black beneficiaries are less likely to be eligible for MTM.

Improving Medication Management by Understanding Patient and Caregiver Preferences for Medication Packaging.

: To assess older adults' perceptions and preferences when comparing multi-medication packaging products.
Qualitative study involving focus group interviews (FGIs) and key informant interviews (KIIs).
Interviews were conducted in multiple cities within the United States during June-July 2019.

Evolution of the Medicare Part D Medication Therapy Management Program from Inception in 2006 to the Present.

Background: In 2006, the Centers for Medicare & Medicaid Services (CMS) implemented the newly established Medicare Part D program that required plan sponsors to offer a medication therapy management (MTM) program. The MTM program requirements have become more prescriptive over the past decade in the attempt to address low beneficiary enrollment rates, improve the quality of services provided, and address gaps in meeting the needs of enrollees.

Objective: To describe changes to the requirements for the Medicare Part D MTM program since its inception in 2006 and the impact of these changes to inform future program enhancements.

Online Provision of Part D Medication Therapy Management Program Information.

Background: Low rates of beneficiary participation in medication therapy management (MTM) programs may be partly due to lack of awareness and understanding of the MTM program. To address this, the Centers for Medicare & Medicaid Services (CMS) requires Medicare Part D sponsors to provide online information about their MTM programs. An early study conducted in 2014 found low compliance rates, with only 59.

Beneficiary, Caregiver, and Case Manager Perspectives on the Medication Therapy Management Program Standardized Format.

Plan sponsors of Medicare Part D must provide beneficiaries who receive a comprehensive medication review (CMR) with a written summary using the Medicare Part D Medication Therapy Management Standardized Format (SF). The SF is a means to advance consistency in the CMR program by providing a template of expected content. However, barriers remain with beneficiary use and integration into existing electronic health records.

Findings from a National Survey of Medicare Beneficiary Perspectives on the Medicare Part D Medication Therapy Management Standardized Format.

Background: The Medication Therapy Management (MTM) Program Standardized Format (SF) is a written summary of a comprehensive medication review (CMR) that must be provided to Medicare Part D beneficiaries. Concerns have been raised regarding the number of pages of the SF, mailing costs, the static nature of the document, and the lack of integration into beneficiaries' electronic health records. To date, limited research exists on beneficiaries' perceptions of the SF.

Medication errors in community pharmacies: The need for commitment, transparency, and research.

Medication errors place a serious medical and economic burden on the United States (U.S.) healthcare system.

Impact of formulary restrictions on medication intensification in diabetes treatment.

Objectives: To explore formulary restrictions on noninsulin antihyperglycemic drugs (NIADs) in Medicare Part D plans and to estimate the impact of formulary restrictions on use of NIADs among low-income subsidy (LIS) recipient enrollees with type 2 diabetes (T2D) undergoing treatment intensification.

Study Design: Retrospective cohort study.

Methods: A cohort of 2919 LIS enrollees with T2D receiving metformin monotherapy during the first quarter of 2012 who intensified treatment later in the year was tracked to assess selection of and days' supply with sulfonylureas, dipeptidyl peptidase-4 (DPP-4) inhibitors, and other NIADs.

Clinical, economic, and humanistic burden of needlestick injuries in healthcare workers.

Introduction: Needlestick injuries (NSIs) from a contaminated needle put healthcare workers (HCWs) at risk of becoming infected with a blood-borne virus and suffering serious short- and long-term medical consequences. Hypodermic injections using disposable syringes and needles are the most frequent cause of NSIs.

Objective: To perform a systematic literature review on NSI and active safety-engineered devices for hypodermic injection.