PDB57 MEDICATION NONADHERENCE AND POTENTIALLY AVOIDABLE HOSPITALIZATIONS AMONG PATIENTS WITH DIABETES

V Thumula, Y Yang, PF Pace, BF Banahan, NE Wilkin, WB Lobb
2009 Value in Health  
Abstracts A107 with target drugs. The purpose of this study was to ascertain whether revocation of the PA requirement resulted in inferior rates of HbA1C testing amongst new users of these drugs. METHODS: Data on of new users of the target drugs and on HbA1C testing in these patients was extracted from EPR databases for the six-month postrevocation period. The proportion of patients who performed at least one HbA1C test during the four months prior to initiation of treatment and 95% confi dence
more » ... intervals were calculated. The data were stratifi ed by month to detect possible trends in rates of testing during the post policy-change period. RESULTS: After rescinding the PA requirement, HbA1C testing amongst incident users of the target drugs dropped from 100% during the PA period to rates of 85.6% (95% CI 79.7, 91.5) to 94.4% (95% CI 90.8, 97.9). Statistically signifi cant variance in monthly rates of testing was not observed. CONCLUSIONS: The PA requirement resulted in total performance of a lab test necessary to monitor drug-therapy outcomes in diabetic patients. When PA is implemented as a quality-assurance strategy, revocation should be accompanied by continuing-education efforts to maintain adherence to recommendations for appropriate care. OBJECTIVES: To measure the impact of pharmacist-provided diabetes management program on the economic, clinical, and humanistic outcomes for the City of Toledo employees and their dependents for a period of 6 months. METHODS: This is a prospective, pre-post longitudinal study. Clinical outcomes collected were A1c, blood pressure (BP), and body mass index (BMI). These outcomes were measured at the baseline, 3 and 6 month visits. Economic outcomes include cost of physician offi ce visits, emergency room visits, and inpatients days. These outcomes were measured at baseline and 6 month visits. Humanistic outcomes collected were quality of life (using Sf36v2), patient satisfaction, adherence with medications, and knowledge about diabetes. The quality of life and knowledge about diabetes were measured at baseline and 6 month visits. The patient satisfaction and adherence with medications (using Morisky scale) were measured at baseline and 3 months visits. Wilcoxon-Signed rank test was used to compare variables at two time points. Friedman test was used to compare variables at multiple time points. Preliminary data analysis for the period between baseline visit to 3 months visit is given below. RESULTS: Ninty fi ve patients have been enrolled to date. Mean A1c's have decreased signifi cantly from 7.78 at baseline visit to 7.44 at 3 months (p 0.05) (N 59). For Intention to treat population (baseline A1C 7), the decrease in A1c is even more signifi cant (p 0.01) (N 33). Diastolic blood pressure has decreased signifi cantly (p .001) while systolic blood pressure and BMI have decreased non-signifi cantly. Self monitoring of blood glucose has increased signifi cantly (p 0.01). Patient satisfaction and adherence with medications has also improved signifi cantly at three-month follow-up visit (p 0.05). Final results for the period between baseline visit to 6 months including economic outcomes will be presented at the ISPOR 14th Annual International Meeting. CONCLUSIONS: Preliminary data analysis showed that pharmacists can improve the clinical outcomes in patients with diabetes.
doi:10.1016/s1098-3015(10)73600-7 fatcat:fnx62dgofvgdznn2vtfuzon5pu