Nonadherence to clinical practice guidelines and medications for multiple chronic conditions in a California Medicaid population

Journal of the American Pharmacists Association : JAPhA
Michael B NicholC Ron Cantrell

Abstract

To assess and profile quality of care in California Medicaid beneficiaries with chronic conditions. Retrospective cohort study. California from 2002 to 2004. 1,123,577 beneficiaries. Eligibility and claims data (2002-2004) were used to identify beneficiaries with dyslipidemia, hypertension, coronary artery disease (CAD), heart failure, or diabetes. Quality of care was based on nonadherence with clinical practice guidelines including recommended medications. Chi-square was used to evaluate nonadherence and patient characteristics. The proportion of patients without a prescription fill for recommended medications varied by disease (43% hypertension, 40% dyslipidemia and CAD, and 25% diabetes and heart failure). For Medicaid-only beneficiaries with diabetes, 78% lacked glycosylated hemoglobin tests, 62% lacked low-density lipoprotein cholesterol tests, and 50% lacked eye exams. Medication nonadherence was high (69% hypertension, 64% CAD, 57% heart failure, 48% dyslipidemia, 41% diabetes). Overall, younger age, Medicaid-only status, and black/other race were associated with poorer rates. Quality of care was suboptimal, with nonadherence varying by condition. Programs targeting both patients and providers and addressing patient-rela...Continue Reading

References

May 26, 1998·JAMA : the Journal of the American Medical Association·J AvornJ LeLorier
May 23, 2001·JAMA : the Journal of the American Medical Association·UNKNOWN Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults
Jul 23, 2002·JAMA : the Journal of the American Medical Association·Joshua S BennerJerry Avorn
Aug 3, 2002·Journal of the National Medical Association·Alan Nelson
Jun 27, 2003·The New England Journal of Medicine·Elizabeth A McGlynnEve A Kerr
Dec 6, 2003·Hypertension·Aram V ChobanianUNKNOWN National High Blood Pressure Education Program Coordinating Committee
Dec 25, 2003·Diabetes Care·UNKNOWN American Diabetes Association
Apr 2, 2004·Inquiry : a Journal of Medical Care Organization, Provision and Financing·Jack Hadley, John Holahan
Jun 27, 2006·Medical Care·Judith M E WalshMary Kane Goldstein
Aug 17, 2006·Journal of Cardiac Failure·David S FrankelLee R Goldberg
Mar 16, 2007·The New England Journal of Medicine·Hoangmai H PhamPeter B Bach
Sep 6, 2007·Annals of Internal Medicine·Kimberly A HepnerLisa V Rubenstein
Oct 11, 2007·JAMA : the Journal of the American Medical Association·Bruce E LandonArnold M Epstein
Feb 2, 2008·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Joyce A CramerPeter K Wong
Mar 28, 2008·Pharmacotherapy·Becky A BriesacherK Arnold Chan
Sep 13, 2008·Journal of General Internal Medicine·Robert A YoodKristijan H Kahler
Jun 2, 2009·Frontiers in Bioscience (Scholar Edition)·Frank Strutz

❮ Previous
Next ❯

Citations

Jan 1, 2012·Medicare & Medicaid Research Review·Michael TaitelIan Duncan
May 28, 2011·Medical Care·Carolyn T ThorpeMaureen A Smith
Mar 29, 2013·Annals of Behavioral Medicine : a Publication of the Society of Behavioral Medicine·Brooke AggarwalLori Mosca
Jan 11, 2014·Journal of the American Pharmacists Association : JAPhA·Martin Nunlee, Michelle Bones
Nov 19, 2011·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Michael S BroderAshley Yegin
May 24, 2011·Urology·Seth A StropeUNKNOWN Urologic Diseases in America Project
Jul 12, 2018·Medical Care·Jeffrey H SilberLee A Fleisher
Oct 8, 2014·The Cochrane Database of Systematic Reviews·Susan M PattersonCarmel Hughes
Apr 28, 2012·Journal of Diabetes Science and Technology·Amanda M BellRobert A Vigersky

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.