Impact of a Pharmacist telephone intervention on medication adherence among Hypertensive Patients with diabetes in a medicare advantage plan

Abstract

OBJECTIVES: To compare 12-month adherence to liraglutide once daily (QD) or exenatide once weekly (QW) between commercially insured patients with type 2 diabetes mellitus (T2DM) newly initiating liraglutide QD or exenatide QW in the U.S. METHODS: This retrospective cohort study used U.S. administrative claims data to study patients with T2DM initiating liraglutide QD or exenatide QW (initiated therapy= index therapy). Patients were included if they had T2DM, were glucagonlike peptide-1 receptor agonist (GLP-1RA)-naïve, initiated liraglutide QD or exenatide QW from 2/1/2012-10/1/2012 (date of initiation= index), were aged ≥ 18y at index, and had continuous enrollment for 12 months before (baseline) to 12 months after index (follow-up). The study outcome was index GLP-1RA adherence (proportion of days covered [PDC] during follow-up, dichotomized at ≥ 80% versus < 80%, and at ≥ 90% versus < 90%). These PDC thresholds have been shown to be predictive of reduced hospitalization and mortality for patients with diabetes. Multivariable logistic regressions compared adherence between the GLP-1RAs, adjusting for potential confounders. Sensitivity analyses were performed separating liraglutide QD by dose (1.2 mg/1.8 mg). RESULTS: Study sample included 10,829 liraglutide QD (4,945 1.2 mg; 5,884 1.8 mg) patients and 3,173 exenatide QW patients. In each group, mean age was approximately 52 years and the proportion of females was 50% for exenatide QW and 54% for liraglutide QD. In multivariable-adjusted analyses, liraglutide QD patients had statistically significant lower odds of achieving a PDC≥ 80% (odds ratio [OR] treating exenatide QW as reference= 0.888, P= .007, 95% confidence interval [CI]= 0.816 to 0.968) and statistically significant lower odds of achieving a PDC≥ 90% (OR= 0.757, P< .001, 95% CI= 0.690 to 0.831) than exenatide QW patients. In sensitivity analyses, results when separating liraglutide QD by dose were directionally consistent. CONCLUSIONS: Patients receiving exenatide QW had greater adjusted odds of clinically significant adherence thresholds compared with patients receiving liraglutide QD in this retrospective analysis.OBJECTIVES: To assess the barriers to treatment adherence on disease management of acromegaly from the provider prospective METHODS: A web-based crosssectional survey was conducted from August -October, 2014. Healthcare providers who had experience in treating acromegaly patients were asked about barriers to treatment adherence and influence on the treatment algorithm based on their experiences and perspectives. RESULTS: A total of 23 providers (mean age: 56 years, female: 48%) completed the survey, including physicians (52%), nurses or nurse practitioners (43%) and research coordinators (5%). Most worked at academic hospitals (78%). Their specialties included endocrinology & metabolism (70%), neuroendocrinology (22%) and neurosurgery (8%). Of the providers, 62% had more than 10 years of experience (range: 5-40 years) treating acromegaly; 75% of them were concerned about the barriers to ...

The Effect of Telephone-Based Follow-Up on Adherence, Efficacy, and Toxicity of Oral Capecitabine-Based Chemotherapy

“…Therefore, special patient education and focused follow-up are required in those receiving such agents. One of the patientfocused services is the telephone-based follow-up postdischarge to deal with any late problems, [18][19][20] which is one of the most efficient and cost-effective methods to follow-up patients. 21 These telephone-based follow-ups, either held by the pharmacist or other healthcare professionals such as nurses, have shown great differences in the expected clinical outcomes.…”