Blood pressure goal attainment according to JNC 7 guidelines and utilization of antihypertensive drug therapy in MCO patients with type 1 or type 2 diabetes.

Objective: Controlling hypertension (HTN) in patients with diabetes mellitus (DM) can reduce complications such as nephropathy, cerebrovascular disease, and cardiovascular disease. As part of a quality improvement project with a managed care organization (MCO), we evaluated blood pressure (BP) control relative to the type of drug therapy for patients with type 1 or type 2 DM who were identified from pharmacy claims for antihyperglycemic drug therapy.

Methods: Pharmacy claims for antihyperglycemic drugs, including insulin, were used to identify a random sample of commercial members in an MCO comprising 30 health plans across the United States.

Uncontrolled blood pressure in a treated, high-risk managed care population.

The prevalence of hypertension in the United States is increasing, and the estimated cost of care is more than USD 55 billion annually, including direct and indirect expenditures. The most recent National Health and Nutrition Examination Survey data show an improvement in awareness, treatment, and control of hypertension compared with previous surveys. Nonetheless, fewer than one third of adults with hypertension are achieving blood pressure control.

Quantifying the effect of applying the NCEP ATP III criteria in a managed care population treated with statin therapy.

Objective: Revised treatment goals suggested by the third report of the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP III) represent a challenge to both physicians and the health care industry. We sought to quantify the impact of these changes in a large managed care population being treated with statin therapy.

Methods: Using data collected from a retrospective chart review of 1,962 managed care enrollees who received statin drug therapy between February 2001 and August 2001, we quantified the low-density lipoprotein cholesterol (LDL-C) goals and goal attainment of this population according to both the NCEP ATP II and ATP III criteria and further identified independent predictors of ATP III goal attainment using multivariable logistic regression modeling.

Utilization patterns of second-line antibiotics in a health plan setting.

Increased utilization of second-line antibiotics where first-line agents are appropriate, and the use of antibiotics for viral infections, are leading to the development of resistance. This retrospective study evaluated antibiotic utilization patterns of cephalosporins, macrolides, and quinolones for community-acquired infections in a health plan's patient population. Patients were identified through the health plan's computerized pharmacy claims database.