A611within and between the MTM members and controls were measured (differencein-differences (DID) analysis). Results: 2382 patients (MTM group: n= 201, mean age= 75,44%male; control group: n= 2181,mean age= 74,48%male) in the diabetes cohort and 9751 patients (MTM group: n= 563, mean age= 76,39% male; control group: n= 9188, mean age= 75,40% male) in the hypertension cohort were included. For patients in diabetes cohort, the MTM group had pre-post increase in PDC by 5.19% (P= 0.05), while the control group had decrease of 2.82% (P< 0.01) (DID= 8.03%; P= 0.003). For patients in hypertension cohort, the MTM group had pre-post increase in PDC by 17.33% (P< 0.01), while the control group had increase of 9.64% (P< 0.01) (DID= 7.67%; P< 0.01). The PDC finding was confirmed with regression analyses with propensity score adjustment showing the MTM groups had a significant increase in pre-post PDC for hypertension, as compared with the control group, while controlling for baseline characteristics (P= 0.01). ConClusions: This study found that the pharmacist-managed MTM program significantly increased medication adherence in Medicare MAPD patients with hypertension, as compared with a control group.
A285claim date was designated as the index date. Continuous health plan enrollment 12 months pre-and post-index date was required. Patients were assigned to four monotherapy AED cohorts based on drug class: sodium channel blockers (SCs), gamma-aminobutyric acid analogs (GABAs), synaptic vesicle protein 2A binding (SV2) and multiple mechanisms (MMs). Adherence was assessed using the proportion of days covered (PDC) and persistence was defined as days to discontinuation with an allowable treatment gap of 45 days without the index AED. Logistic and Cox proportional hazards models were used to compare the results among the cohorts. RESULTS: Patients in the SC cohort had significantly lower baseline Charlson Comorbidity Index scores (1.82), indicating that they were healthier than those in the GAMA (2.08, p< 0.001) and SV2 (2.46, p< 0.001) cohorts. Patients in the SC cohort were significantly less likely to have a baseline psychiatric disorder (37.6%) than those in the GABA (63.8%, p< 0.001) and MM (52.1%, p< 0.001) cohorts. Patients treated with GABAs (OR= 0.44, p< 0.001) and MMs (OR= 0.63, p< 0.001) were significantly less likely to adhere to their medications (PDC < 80%) than those treated with SC. Furthermore, patients treated with GABAs (hazard ratio [HR]= 1.74; 95% confidence interval [CI]= 1.59-1.90) and MMs (HR= 1.18; 95% CI= 1.07-1.29) were more likely to discontinue treatment during the follow-up period compared to those in the SC cohort. CONCLUSIONS: Patients treated with Sodium channel blockers are more likely adhere to treatment and have lower discontinuation of AED monotherapy than those treated with GABAs and MMs.
PND44 MeasuriNg aDhereNce aND outcoMe iN treatMeNt of MultiPle sclerosis iN the geisiNger cliNic
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