Predictors of Medication-Related Problems Among Medicaid Patients Participating in a Pharmacist-Provided Telephonic Medication Therapy Management Program
Identifieur interne : 002B57 ( Ncbi/Merge ); précédent : 002B56; suivant : 002B58Predictors of Medication-Related Problems Among Medicaid Patients Participating in a Pharmacist-Provided Telephonic Medication Therapy Management Program
Auteurs : Margie E. Snyder ; Caitlin K. Frail ; Heather Jaynes ; Karen S. Pater ; Alan J. ZillichSource :
- Pharmacotherapy [ 0277-0008 ] ; 2014.
Abstract
To identify predictors of medication-related problems (MRPs) among Medicaid patients participating in a telephonic medication therapy management (MTM) program.
Retrospective analysis of data from patients enrolled in a previously published study
Two Medicaid administrative claims file databases (for healthcare utilization and prescription dispensing information) and one pharmacy organization file for MTM program information.
Seven hundred twelve adult Medicaid patients who participated in a statewide pharmacist-provided telephone-based MTM program and who received an initial medication therapy review.
The primary dependent variable was the number of MRPs detected during the initial medication therapy review. Secondary dependent variables were the detection of one or more MRPs related to indication, effectiveness, safety, and adherence. Predictor variables were selected a priori that, from the literature and our own practice experiences, were hypothesized as being potentially associated with MRPs: demographics, comorbidities, medication use, and healthcare utilization. Bivariate analyses were performed, and multivariable models were constructed. All predictor variables with significant associations (defined a priori as p<0.1) with the median number of MRPs detected were then entered into a three-block multiple linear regression model. The overall model was significant (p<0.001, R2= 0.064). Significant predictors of any MRPs (p<0.05) were total number of medications, obesity, dyslipidemia, and one or more emergency department visits in the past 3 months. For indication-related MRPs, the model was significant (p<0.001, R2= 0.049), and predictors included female sex, obesity, dyslipidemia, and total number of medications (p<0.05). For effectiveness-related MRPs, the model was significant (p<0.001, R2= 0.054), and predictors included bone disease and dyslipidemia (p<0.05). For safety-related MRPs, the model was significant (p<0.001, R2= 0.046), and dyslipidemia was a predictor (p<0.05). No significant predictors of adherence-related MRPs were identified.
This analysis supports the relative importance of number of medications as a predictor of MRPs in the Medicaid population and identifies other predictors. However, given the models’ low R2 values, these findings indicate that other unknown factors are clearly important and that criteria commonly used for determining MTM eligibility may be inadequate in identifying appropriate patients for MTM in a Medicaid population.
Url:
DOI: 10.1002/phar.1462
PubMed: 25051943
PubMed Central: 4426336
Links toward previous steps (curation, corpus...)
- to stream Pmc, to step Corpus: 001509
- to stream Pmc, to step Curation: 001484
- to stream Pmc, to step Checkpoint: 000930
Links to Exploration step
PMC:4426336Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Predictors of Medication-Related Problems Among Medicaid Patients Participating in a Pharmacist-Provided Telephonic Medication Therapy Management Program</title>
<author><name sortKey="Snyder, Margie E" sort="Snyder, Margie E" uniqKey="Snyder M" first="Margie E." last="Snyder">Margie E. Snyder</name>
</author>
<author><name sortKey="Frail, Caitlin K" sort="Frail, Caitlin K" uniqKey="Frail C" first="Caitlin K." last="Frail">Caitlin K. Frail</name>
</author>
<author><name sortKey="Jaynes, Heather" sort="Jaynes, Heather" uniqKey="Jaynes H" first="Heather" last="Jaynes">Heather Jaynes</name>
</author>
<author><name sortKey="Pater, Karen S" sort="Pater, Karen S" uniqKey="Pater K" first="Karen S." last="Pater">Karen S. Pater</name>
</author>
<author><name sortKey="Zillich, Alan J" sort="Zillich, Alan J" uniqKey="Zillich A" first="Alan J." last="Zillich">Alan J. Zillich</name>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">25051943</idno>
<idno type="pmc">4426336</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4426336</idno>
<idno type="RBID">PMC:4426336</idno>
<idno type="doi">10.1002/phar.1462</idno>
<date when="2014">2014</date>
<idno type="wicri:Area/Pmc/Corpus">001509</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001509</idno>
<idno type="wicri:Area/Pmc/Curation">001484</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001484</idno>
<idno type="wicri:Area/Pmc/Checkpoint">000930</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000930</idno>
<idno type="wicri:Area/Ncbi/Merge">002B57</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Predictors of Medication-Related Problems Among Medicaid Patients Participating in a Pharmacist-Provided Telephonic Medication Therapy Management Program</title>
<author><name sortKey="Snyder, Margie E" sort="Snyder, Margie E" uniqKey="Snyder M" first="Margie E." last="Snyder">Margie E. Snyder</name>
</author>
<author><name sortKey="Frail, Caitlin K" sort="Frail, Caitlin K" uniqKey="Frail C" first="Caitlin K." last="Frail">Caitlin K. Frail</name>
</author>
<author><name sortKey="Jaynes, Heather" sort="Jaynes, Heather" uniqKey="Jaynes H" first="Heather" last="Jaynes">Heather Jaynes</name>
</author>
<author><name sortKey="Pater, Karen S" sort="Pater, Karen S" uniqKey="Pater K" first="Karen S." last="Pater">Karen S. Pater</name>
</author>
<author><name sortKey="Zillich, Alan J" sort="Zillich, Alan J" uniqKey="Zillich A" first="Alan J." last="Zillich">Alan J. Zillich</name>
</author>
</analytic>
<series><title level="j">Pharmacotherapy</title>
<idno type="ISSN">0277-0008</idno>
<idno type="eISSN">1875-9114</idno>
<imprint><date when="2014">2014</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Study Objective</title>
<p id="P2">To identify predictors of medication-related problems (MRPs) among Medicaid patients participating in a telephonic medication therapy management (MTM) program.</p>
</sec>
<sec id="S2"><title>Design</title>
<p id="P3">Retrospective analysis of data from patients enrolled in a previously published study</p>
</sec>
<sec id="S3"><title>Data Sources</title>
<p id="P4">Two Medicaid administrative claims file databases (for healthcare utilization and prescription dispensing information) and one pharmacy organization file for MTM program information.</p>
</sec>
<sec id="S4"><title>Patients</title>
<p id="P5">Seven hundred twelve adult Medicaid patients who participated in a statewide pharmacist-provided telephone-based MTM program and who received an initial medication therapy review.</p>
</sec>
<sec id="S5"><title>Measurements and Main Results</title>
<p id="P6">The primary dependent variable was the number of MRPs detected during the initial medication therapy review. Secondary dependent variables were the detection of one or more MRPs related to indication, effectiveness, safety, and adherence. Predictor variables were selected a priori that, from the literature and our own practice experiences, were hypothesized as being potentially associated with MRPs: demographics, comorbidities, medication use, and healthcare utilization. Bivariate analyses were performed, and multivariable models were constructed. All predictor variables with significant associations (defined a priori as p<0.1) with the median number of MRPs detected were then entered into a three-block multiple linear regression model. The overall model was significant (p<0.001, R<sup>2</sup>
= 0.064). Significant predictors of any MRPs (p<0.05) were total number of medications, obesity, dyslipidemia, and one or more emergency department visits in the past 3 months. For indication-related MRPs, the model was significant (p<0.001, R<sup>2</sup>
= 0.049), and predictors included female sex, obesity, dyslipidemia, and total number of medications (p<0.05). For effectiveness-related MRPs, the model was significant (p<0.001, R<sup>2</sup>
= 0.054), and predictors included bone disease and dyslipidemia (p<0.05). For safety-related MRPs, the model was significant (p<0.001, R<sup>2</sup>
= 0.046), and dyslipidemia was a predictor (p<0.05). No significant predictors of adherence-related MRPs were identified.</p>
</sec>
<sec id="S6"><title>Conclusion</title>
<p id="P7">This analysis supports the relative importance of number of medications as a predictor of MRPs in the Medicaid population and identifies other predictors. However, given the models’ low R<sup>2</sup>
values, these findings indicate that other unknown factors are clearly important and that criteria commonly used for determining MTM eligibility may be inadequate in identifying appropriate patients for MTM in a Medicaid population.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8111305</journal-id>
<journal-id journal-id-type="pubmed-jr-id">6511</journal-id>
<journal-id journal-id-type="nlm-ta">Pharmacotherapy</journal-id>
<journal-id journal-id-type="iso-abbrev">Pharmacotherapy</journal-id>
<journal-title-group><journal-title>Pharmacotherapy</journal-title>
</journal-title-group>
<issn pub-type="ppub">0277-0008</issn>
<issn pub-type="epub">1875-9114</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25051943</article-id>
<article-id pub-id-type="pmc">4426336</article-id>
<article-id pub-id-type="doi">10.1002/phar.1462</article-id>
<article-id pub-id-type="manuscript">NIHMS685559</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Predictors of Medication-Related Problems Among Medicaid Patients Participating in a Pharmacist-Provided Telephonic Medication Therapy Management Program</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Snyder</surname>
<given-names>Margie E.</given-names>
</name>
<role>Assistant Professor of Pharmacy Practice</role>
<aff id="A1">Department of Pharmacy Practice, Purdue University College of Pharmacy, Indianapolis, Indiana</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Frail</surname>
<given-names>Caitlin K.</given-names>
</name>
<role>Assistant Professor</role>
<xref ref-type="author-notes" rid="FN1">*</xref>
<aff id="A2">Department of Pharmaceutical Care and Health Systems, University of Minnesota College of Pharmacy, Minneapolis, Minnesota</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Jaynes</surname>
<given-names>Heather</given-names>
</name>
<role>Research Nurse</role>
<aff id="A3">Department of Pharmacy Practice, Purdue University College of Pharmacy, Indianapolis, Indiana</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Pater</surname>
<given-names>Karen S.</given-names>
</name>
<role>Assistant Professor of Pharmacy and Therapeutics</role>
<aff id="A4">Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Zillich</surname>
<given-names>Alan J.</given-names>
</name>
<role>Associate Professor of Pharmacy Practice</role>
<aff id="A5">Department of Pharmacy Practice, Purdue University College of Pharmacy, Research Scientist, Center for Implementing Evidence-Based Practices, Roudebush VA Medical Center, Indianapolis, Indiana</aff>
</contrib>
</contrib-group>
<author-notes><corresp id="cor1">Corresponding Author: Margie E. Snyder, Assistant Professor of Pharmacy Practice, Purdue University College of Pharmacy, 640 Eskenazi Ave. Indianapolis, IN 46202, Tel: 317-880-5429, Fax: 317-880-0568, <email>snyderme@purdue.edu</email>
</corresp>
<fn id="FN1"><label>*</label>
<p id="P1">At the time of this study: Community Practice Research Fellow, Purdue University College of Pharmacy, Indianapolis, Indiana</p>
</fn>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>1</day>
<month>5</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub"><day>23</day>
<month>7</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="ppub"><month>10</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>10</month>
<year>2015</year>
</pub-date>
<volume>34</volume>
<issue>10</issue>
<fpage>1022</fpage>
<lpage>1032</lpage>
<pmc-comment>elocation-id from pubmed: 10.1002/phar.1462</pmc-comment>
<abstract><sec id="S1"><title>Study Objective</title>
<p id="P2">To identify predictors of medication-related problems (MRPs) among Medicaid patients participating in a telephonic medication therapy management (MTM) program.</p>
</sec>
<sec id="S2"><title>Design</title>
<p id="P3">Retrospective analysis of data from patients enrolled in a previously published study</p>
</sec>
<sec id="S3"><title>Data Sources</title>
<p id="P4">Two Medicaid administrative claims file databases (for healthcare utilization and prescription dispensing information) and one pharmacy organization file for MTM program information.</p>
</sec>
<sec id="S4"><title>Patients</title>
<p id="P5">Seven hundred twelve adult Medicaid patients who participated in a statewide pharmacist-provided telephone-based MTM program and who received an initial medication therapy review.</p>
</sec>
<sec id="S5"><title>Measurements and Main Results</title>
<p id="P6">The primary dependent variable was the number of MRPs detected during the initial medication therapy review. Secondary dependent variables were the detection of one or more MRPs related to indication, effectiveness, safety, and adherence. Predictor variables were selected a priori that, from the literature and our own practice experiences, were hypothesized as being potentially associated with MRPs: demographics, comorbidities, medication use, and healthcare utilization. Bivariate analyses were performed, and multivariable models were constructed. All predictor variables with significant associations (defined a priori as p<0.1) with the median number of MRPs detected were then entered into a three-block multiple linear regression model. The overall model was significant (p<0.001, R<sup>2</sup>
= 0.064). Significant predictors of any MRPs (p<0.05) were total number of medications, obesity, dyslipidemia, and one or more emergency department visits in the past 3 months. For indication-related MRPs, the model was significant (p<0.001, R<sup>2</sup>
= 0.049), and predictors included female sex, obesity, dyslipidemia, and total number of medications (p<0.05). For effectiveness-related MRPs, the model was significant (p<0.001, R<sup>2</sup>
= 0.054), and predictors included bone disease and dyslipidemia (p<0.05). For safety-related MRPs, the model was significant (p<0.001, R<sup>2</sup>
= 0.046), and dyslipidemia was a predictor (p<0.05). No significant predictors of adherence-related MRPs were identified.</p>
</sec>
<sec id="S6"><title>Conclusion</title>
<p id="P7">This analysis supports the relative importance of number of medications as a predictor of MRPs in the Medicaid population and identifies other predictors. However, given the models’ low R<sup>2</sup>
values, these findings indicate that other unknown factors are clearly important and that criteria commonly used for determining MTM eligibility may be inadequate in identifying appropriate patients for MTM in a Medicaid population.</p>
</sec>
</abstract>
<kwd-group><kwd>administration</kwd>
<kwd>outcomes</kwd>
<kwd>pharmacy practice</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
<affiliations><list></list>
<tree><noCountry><name sortKey="Frail, Caitlin K" sort="Frail, Caitlin K" uniqKey="Frail C" first="Caitlin K." last="Frail">Caitlin K. Frail</name>
<name sortKey="Jaynes, Heather" sort="Jaynes, Heather" uniqKey="Jaynes H" first="Heather" last="Jaynes">Heather Jaynes</name>
<name sortKey="Pater, Karen S" sort="Pater, Karen S" uniqKey="Pater K" first="Karen S." last="Pater">Karen S. Pater</name>
<name sortKey="Snyder, Margie E" sort="Snyder, Margie E" uniqKey="Snyder M" first="Margie E." last="Snyder">Margie E. Snyder</name>
<name sortKey="Zillich, Alan J" sort="Zillich, Alan J" uniqKey="Zillich A" first="Alan J." last="Zillich">Alan J. Zillich</name>
</noCountry>
</tree>
</affiliations>
</record>
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Amérique/explor/PittsburghV1/Data/Ncbi/Merge
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 002B57 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Ncbi/Merge/biblio.hfd -nk 002B57 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Wicri/Amérique |area= PittsburghV1 |flux= Ncbi |étape= Merge |type= RBID |clé= PMC:4426336 |texte= Predictors of Medication-Related Problems Among Medicaid Patients Participating in a Pharmacist-Provided Telephonic Medication Therapy Management Program }}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Ncbi/Merge/RBID.i -Sk "pubmed:25051943" \ | HfdSelect -Kh $EXPLOR_AREA/Data/Ncbi/Merge/biblio.hfd \ | NlmPubMed2Wicri -a PittsburghV1
This area was generated with Dilib version V0.6.38. |