Effect of cost-sharing for prescription medications on health outcomes in older adults: a critical review of the literature and potential implications for managed care.

Objective: To review the literature addressing the relationship between increased cost-sharing of prescription medications within a managed care setting and health outcomes in older adults.

Data Source: A Medline/preMedline search (1950 to August 21, 2007) was conducted to identify pertinent peer-review studies with robust study designs specifically addressing cost-sharing of prescription medications and health outcomes.

Study Selection And Data Extraction: Studies were selected if they were conducted within a managed care environment, evaluated prescription medications, provided specifics regarding health outcomes, and did not focus on a solitary chronic disease state or medication class.

The slow pace of interactive video telemedicine adoption: the perspective of telemedicine program administrators on physician participation.

We conducted semistructured interviews with telemedicine program administrators as part of a national survey of physicians and managers regarding attitudes toward, and knowledge of, telemedicine. Telemedicine administrators were interviewed regarding factors affecting physician adoption of interactive video (IAV) telemedicine. The seven networks with which these managers were affiliated represented "traditional" telemedicine programs, primarily providing specialty teleconsultation via IAV.

Specialist physicians' knowledge and beliefs about telemedicine: a comparison of users and nonusers of the technology.

Telemedicine as a technology has been available for nearly 50 years, but its diffusion has been slower than many had anticipated. Even efforts to reimburse providers for interactive video (IAV) telemedicine services have had a limited effect on rates of participation. The resulting low volume of services provided (and consequent paucity of research subjects) makes the phenomenon difficult to study.

Diabetes, minor depression and health care utilization and expenditures: a retrospective database study.

Background: To estimate the prevalence of minor depression among US adults with diabetes, health care resource utilization, and expenditures by people with diabetes with and without minor depression.

Methods: Among adult 2003 Medical Expenditure Panel Survey respondents, diabetes was identified by diagnosis code and self-report. Depression was identified by diagnosis code plus > or = one antidepressant prescription.

Barriers to quality care for dying patients in rural communities.

Context: Barriers to providing optimal palliative care in rural communities are not well understood.

Purpose: To identify health care personnel's perceptions of the care provided to dying patients in rural Kansas and Colorado and to identify barriers to providing optimal care.

Methods: An anonymous self-administered survey was sent to health care personnel throughout 2 rural practice-based research networks.

The effect of FDA approval of a generic competitor to OxyContin (oxycodone HCl controlled-release) tablets on the abuse of oxycodone.

Controversy exists concerning whether abuse of oxycodone will increase after the introduction of generic controlled-release (CR) oxycodone. We evaluated the effect of FDA approval of generic CR oxycodone on the misuse/abuse of oxycodone, hydrocodone, methadone and morphine utilizing data from eight poison control centers (PCC). PCC intentional exposure (IE) reason codes were used as measures of abuse.

Antidepressant treatment improves adherence to antiretroviral therapy among depressed HIV-infected patients.

Background: Antiretroviral regimens for HIV-infected patients require strict adherence. Untreated depression has been associated with medication nonadherence. We proposed to evaluate the effect of antidepressant treatment (ADT) on antiretroviral adherence.

A cost-effectiveness analysis of four management strategies in the determination and follow-up of atypical squamous cells of undetermined significance.

Atypical squamous cells of undetermined significance (ASC-US) are the most common abnormal cytological result on Papanicolaou (Pap) smear. We analyzed four management strategies in a hypothetical cohort of women divided by age group: (1) immediate colposcopy, (2) repeat cytology after an ASC-US Pap smear result, (3) conventional Pap with reflex human papillomavirus (HPV) testing, and (4) liquid-based cytology with reflex HPV testing. Parameter variables were collected from previously published data.

Are low-income elderly patients at risk for poor diabetes care?

Objective: Diabetes is common among low-income elderly, dual-eligible (DE) Medicare/Medicaid patients resulting in significant morbidity, mortality, and cost. However, the quality of diabetes care delivered to these patients has not been evaluated. The aims of this study were to describe the quality of diabetes care provided to DE patients and compare it with non-DE patients.