Working Agenda for Black Mothers: A Position Paper From the Association of Black Cardiologists on Solutions to Improving Black Maternal Health.

Following decades of decline, maternal mortality began to rise in the United States around 1990-a significant departure from the world's other affluent countries. By 2018, the same could be seen with the maternal mortality rate in the United States at 17.4 maternal deaths per 100 000 live births.

Medical Costs and Health Care Utilization Among Self-Insured Members with Carve-In Versus Carve-Out Pharmacy Benefits.

Background: Pharmacy benefit can be purchased as part of an integrated medical and pharmacy health package-a carve-in model-or purchased separately and administered by an external pharmacy benefit manager-a carve-out model. Limited peer-reviewed information is available assessing differences in use and medical costs among carve-in versus carve-out populations.

Objective: To compare total medical costs per member per year (PMPY) and utilization between commercially self-insured members receiving carve-in to those receiving carve-out pharmacy benefits overall and by 7 chronic condition subgroups.

Achieving Health Equity by Normalizing Cardiac Care.

It is well known that minority patients, and particularly African Americans undergo lower rates of cardiac procedures than the white population, even when covered by equivalent insurance. We analyzed the rates of percutaneous transluminal coronary angioplasty (PTCA) for acute myocardial infarction (AMI) and for intermediate coronary syndrome (ICS), and rates of transcatheter aortic valve replacement for aortic stenosis in the 2012-2013 Medicare Limited Data Set (5% sample) file. Although blacks have similar prevalence rates for AMI and ICS, they experience lower PTCA rates when compared with that of white patients (10.

Disparities in Health Care Utilization and Functional Limitations Among Adults With Serious Psychological Distress, 2006-2014.

Objective: This study compared health care access, utilization, and functional indicators among adults with and without serious psychological distress (SPD) in the years surrounding implementation of the Patient Protection and Affordable Care Act (ACA).

Methods: Adults ages 18 to 64 from the 2006-2014 National Health Interview Survey (N=207, 853) were examined on 11 access, utilization, and functional indicators: health insurance coverage (health coverage), insufficient money for medications, delay in health care (delay in care), insufficient money for health care, visiting a doctor ten or more times in the past 12 months, change in place of health care, change in place of health care due to insurance, limitations in ability to work, limitations in activities of daily living (ADLs), insufficient money for mental health care, and having seen a mental health care provider.

Results: Multivariate models that were adjusted for health coverage and sociodemographic characteristics indicated that compared with adults without SPD, adults with SPD had greater odds of lacking money for medications (AOR=10.

Oral chemotherapy program improves adherence and reduces medication wastage and hospital admissions.

Adherence, medication wastage, and reduction in hospital admissions were investigated in a retrospective test-control study design for patients enrolled in the oral chemotherapy cycle management program (CMP), a program that offers clinical support, dose monitoring, and early identification of side effects for patients on select oral chemotherapy. Patients who initiated oral chemotherapy with sorafenib, sunitinib, or erlotinib during June 2008 through December 2009 and who were enrolled in the CMP were included as a test group. Patients who initiated oral chemotherapy with these drugs using Walgreens Specialty Pharmacy during January 2007 through May 2008 and were not part of the CMP were included as control group 1, and patients from a national payor database who initiated therapy with sorafenib, sunitinib, or erlotinib during June 2008 through August 2010 were included as control group 2.

Community pharmacy and mail order cost and utilization for 90-day maintenance medication prescriptions.

Background: Pharmacy benefit management (PBM) companies promote mail order programs that typically dispense 90-day quantities of maintenance medications, marketing this feature as a key cost containment strategy to address plan sponsors' rising prescription drug expenditures. In recent years, community pharmacies have introduced 90-day programs that provide similar cost advantages, while allowing these prescriptions to be dispensed at the same pharmacies that patients frequent for 30-day quantities.

Objective: To compare utilization rates and corresponding costs associated with obtaining 90-day prescriptions at community and mail order pharmacies for payers that offer equivalent benefits in different 90-day dispensing channels.

Impact of an online prescription management account on medication adherence.

Objectives: To assess medication adherence rates of patients utilizing an online prescription management account compared with nonusers.

Study Design: A retrospective analysis was conducted using de-identified pharmacy claims data from a pharmacy benefit manager covering the period from April 1, 2009, to March 31, 2011. Patients who were continuously eligible throughout the study period and that had at least 1 prescription fill for any of the 8 therapeutic groups examined in the study were selected for inclusion.

The value of pharmacists in health care.

The American health care system is concerned about the rise of chronic diseases and related resource challenges. Management of chronic disease traditionally has been provided by physicians and nurses. The growth of the care management industry, in which nurses provide remote telephonic monitoring and coaching, testifies to the increasing need for care management and to the value of nonphysician clinicians.

Medication adherence for 90-day quantities of medication dispensed through retail and mail order pharmacies.

Objectives: To examine relative medication adherence of patients filling 90-day supplies of maintenance medications using retail and mail order channels. It was hypothesized that adherence rates would not differ across the 2 channels.

Study Design: A cross-sectional retrospective analysis was conducted using de-identified pharmacy claims data from a large pharmacy benefit manager (PBM) database over a 2-year period (January 2008 to August 2010).

Impact of clinical oral chemotherapy program on wastage and hospitalizations.

Purpose: The oral chemotherapy cycle management program (CMP) provides clinical management support to patients receiving certain oral chemotherapies. The CMP includes a dose-monitoring (ie, split-fill) plan for early identification and management of adverse effects. If serious adverse effects are identified mid cycle, the remainder of the monthly supply is withheld, thus avoiding potential waste associated with early therapy discontinuation.

Pharmacists as providers: targeting pneumococcal vaccinations to high risk populations.

Background: Older adults and persons with chronic conditions are at increased risk for pneumococcal disease. Severe pneumococcal disease represents a substantial humanistic and economic burden to society. Although pneumococcal vaccination (PPSV) can decrease risk for serious consequences, vaccination rates are suboptimal.

Place of death among patients with terminal heart failure in a continuous inotropic infusion program.

Although most patients with terminal heart failure (HF) prefer to die at home, the majority die in hospitals. To determine the impact of home inotropic support in the place of death among patients with terminal HF, this retrospective study compared the place of death in patients with terminal HF enrolled in an inotropic infusion program to place of death in a national sample of patients with HF. The rate of home death among program participants (64.

Impact of clinical oral chemotherapy program on wastage and hospitalizations.

Objective: The oral chemotherapy cycle management program (CMP) provides clinical management support to patients receiving certain oral chemotherapies. The CMP includes a dose-monitoring (ie, split-fill) plan for early identification and management of adverse effects. If serious adverse effects are identified mid cycle, the remainder of the monthly supply is withheld, thus avoiding potential waste associated with early therapy discontinuation.

Cardiovascular Disease urban intervention: baseline activities and findings.

Regular exercise, good dietary habits, knowledge of the disease and its warning signs as well as ability to perform CPR (cardiopulmonary resuscitation) are all important to prevent and combat Cardiovascular Disease (CVD) and Stroke. In 2005-2006, an AHA sponsored "Search Your Heart" cardiovascular disease intervention was conducted in 388 urban African-American/black and Latino/Hispanic faith based institutions, all churches of various denominations, to improve members' knowledge and preparedness about CVD and stroke. The intervention involved (a) distribution of a customized multi-component CVD and stroke related educational and skill development package to 388 "ambassadors" for all participating churches, (b) AHA staff coordinated educational sessions for the ambassadors and (c) 211 Ambassadors coordinating the conduct of at least one CVD educational activities in their churches.

Effect of the Heart At Work program on awareness of risk factors, self-efficacy, and health behaviors.

This study evaluates the effects of the American Heart Association's Heart At Work program on cardiovascular disease risk factor awareness, self-efficacy, and health behaviors. A prospective, quasi-experimental research design was used to assess the impact of the program at two factory sites (one intervention and one control). A total of 633 employees participated.