Retrospective Review of Exceptions for Angiotensin-Converting Enzyme Inhibitor or Angiotensin II Receptor Blocker Recommendations for a Diabetic Medicare Population

Journal of Managed Care & Specialty Pharmacy
Chanadda ChinthammitTerri L Warholak

Abstract

Renin-angiotensin system (RAS) antagonists are recommended for people with diabetes and hypertension or with elevated urinary albumin excretion. RAS antagonists are beneficial for some, yet clinically inappropriate for others. The percentage of patients for whom RASs are clinically inappropriate has not been compared across health plans. To (a) identify reasons why RAS therapy was not recommended and (b) compare exception percentages between health plans. This retrospective, cross-sectional analysis included Medicare Part D beneficiaries with diabetes, enrolled in health plans (n = 96) participating in a university-based medication therapy management (MTM) program between January 1 and December 31, 2013. The MTM program evaluated patient eligibility for RAS therapy via (1) a clinically derived software system assessing demographics and medication history, and (2) telepharmacist-delivered medication reviews. The MTM program database calculated the number of patients with diabetes and percentage of RAS therapy exceptions. An average of 55% of patients with diabetes qualified for MTM (range: 19%-88%). Of the 218,589 eligible, 94,359 had 1 or more reasons contraindicating RAS therapy (exception). For an average of 29% of patients, ...Continue Reading

References

Jan 26, 2005·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Alan M Zaslavsky, Arnold M Epstein
Aug 23, 2005·Journal of the American Academy of Dermatology·Allen P Kaplan, Malcolm W Greaves
Jul 27, 2006·Progress in Cardiovascular Diseases·Ehud Grossman, Franz H Messerli
Oct 26, 2006·JAMA : the Journal of the American Medical Association·Amal N TrivediJohn Z Ayanian
Feb 25, 2009·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Wilbert S Aronow
Jul 2, 2010·British Journal of Pharmacology·Terry K W MaYat-Yin Lam
Jan 4, 2013·Diabetes Care·UNKNOWN American Diabetes Association
Dec 14, 2016·The New England Journal of Medicine·Rachel E ShermanRobert M Califf

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Citations

Sep 23, 2020·Nutrients·Tawar QaradakhiAnthony Zulli

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