Good and poor adherence: optimal cut-point for adherence measures using administrative claims data.

Objective: To identify the adherence value cut-off point that optimally stratifies good versus poor compliers using administratively derived adherence measures, the medication possession ratio (MPR) and the proportion of days covered (PDC) using hospitalization episode as the primary outcome among Medicaid eligible persons diagnosed with schizophrenia, diabetes, hypertension, congestive heart failure (CHF), or hyperlipidemia.

Research Design And Methods: This was a retrospective analysis of Arkansas Medicaid administrative claims data. Patients > or =18 years old had to have at least one ICD-9-CM code for the study diseases during the recruitment period July 2000 through April 2004 and be continuously eligible for 6 months prior and 24 months after their first prescription for the target condition.

Prospective validation of eight different adherence measures for use with administrative claims data among patients with schizophrenia.

Objective: The aim of this study was to compare the predictive validity of eight different adherence measures by studying the variability explained between each measure and hospitalization episodes among Medicaid-eligible persons diagnosed with schizophrenia on antipsychotic monotherapy.

Methods: This study was a retrospective analysis of the Arkansas Medicaid administrative claims data. Continuously eligible adult schizophrenia (ICD-9-CM = 295.

An empirical basis for standardizing adherence measures derived from administrative claims data among diabetic patients.

Objective: To compare the predictive validity of 8 different adherence measures by studying the variability explained between each measure and 2 outcome measures: hospitalization episodes and total nonpharmacy cost among Medicaid eligible persons diagnosed with diabetes.

Research Design: This study was a retrospective analysis of the Arkansas Medicaid administrative claims data from January 2000 to December 2006.

Subjects: Diabetic (ICD-9-CM = 250.

Prevalence and treatment of metabolic syndrome in adolescents with type 2 diabetes.

Background: The incidence of obesity and type 2 diabetes among adolescents has risen dramatically in recent years, and it is likely that many of these adolescents also have metabolic syndrome.

Objective: To investigate the prevalence of metabolic syndrome in the patient population enrolled in a children's hospital type 2 diabetes clinic and to describe baseline pharmacologic treatment and adherence patterns.

Methods: In this retrospective cohort study, the medical charts of 52 adolescents were reviewed.

Assessment of medication management by community-living elderly persons with two standardized assessment tools: a cross-sectional study.

Background: The ability of patients to adhere to a medication regimen is imperative for achieving optimal outcomes. Elderly patients, especially those with memory loss, should be evaluated for their ability to manage medications to prevent significant drug-related problems. Assessment tools to determine the ability to manage medication therapy have not been tested in elderly patients with cognitive impairment.

A 30-month evaluation of the effects on the cost and utilization of proton pump inhibitors from adding omeprazole OTC to drug benefit coverage in a state employee health plan.

Objective: On March 1, 2004, the state employee health plan began covering omeprazole OTC (over the counter) at a $5 copayment. Reimbursement to pharmacy providers for omeprazole OTC increased by $10.50 per claim, from $2.

Effects of a medication assistance program on health outcomes in patients with type 2 diabetes mellitus.

Purpose: The effects of a clinic-based medication assistance program (MAP) on the health outcomes and medication use of patients with type 2 diabetes mellitus were studied.

Methods: In this retrospective analysis, data from the University of Arkansas for Medical Sciences pharmacy-managed MAP and outpatient pharmacy databases were collected for adult patients with type 2 diabetes mellitus who were monitored in the university's internal medicine clinic one year before and after enrollment in the MAP. Data on patient demographics, medication use, and disease indicators (glycosylated hemoglobin [HbA(1c)], high-density-lipoprotein [HDL] cholesterol, low-density-lipoprotein [LDL] cholesterol, total cholesterol, triglyceride, and blood pressure levels) were collected for the year before enrollment and for one year after enrollment.

Effects on the cost and utilization of proton pump inhibitors from adding over-the counter omeprazole to drug benefit coverage in a state employee health plan.

Objective: To evaluate the financial effects in a state employee health plan of a change in the drug coverage policy to include over-the-counter (OTC) omeprazole in a tier-copayment drug benefit design that favored the OTC drug.

Methods: The policy change in the Arkansas State Employee Benefit Division (EBD) involved 2 principal parts: OTC omeprazole placed in a new OTC copayment tier (5 dollars) and an increase in pharmacy reimbursement to a 13 dollars dispensing fee for each OTC omeprazole prescription. The prescription claims database was used to examine utilization and cost data for beneficiaries who received prescriptions for a proton pump inhibitor (PPI) during the 2-month period (January and February 2004) preceding the change in policy to cover OTC omeprazole compared with the 2-month period following the policy change (March and April 2004).

Role of pharmacy experience and argument types in forming beliefs about pharmacist trustworthiness.

The role of pharmacy experience and argument types in forming beliefs about pharmacist trustworthiness was studied. Study participants were recruited from three primary care clinics. They were provided a pharmacy scenario that contained information that could be used to form causal and authoritative arguments.

Understanding how patients form beliefs about pharmacists' trustworthiness using a model of belief processing.

Objective: To determine what information people use in forming beliefs about pharmacists' trustworthiness and to determine whether these pieces of information can be categorized using elements of a model of belief processing.

Design: Participants in two focus groups were asked about the trustworthiness of pharmacists in one dispensing scenario and two pharmaceutical care scenarios. Transcripts were analyzed, and each piece of information provided was coded as an evidence statement or a claim, according to a model of belief processing.