PMID- 19289345
OWN - NLM
STAT- MEDLINE
DCOM- 20090619
LR  - 20090317
IS  - 1544-3450 (Electronic)
IS  - 1086-5802 (Linking)
VI  - 49
IP  - 2
DP  - 2009 Mar-Apr
TI  - A medication therapy management program's impact on low-density lipoprotein 
      cholesterol goal attainment in Medicare Part D patients with diabetes.
PG  - 192-9
LID - 10.1331/JAPhA.2009.09016 [doi]
AB  - OBJECTIVES: To determine a medication therapy management (MTM) service's impact 
      on (1) Healthcare Effectiveness Data and Information Set (HEDIS) quality measures 
      and (2) use and cost expenditures. DESIGN: Nonequivalent group, quasiexperimental 
      study. SETTING: Florida, January 1, 2006, through September 30, 2007. 
      PARTICIPANTS: 2,114 Florida Health Care Plans Medicare Part D enrollees with 
      diabetes. INTERVENTION: Intervention group participated in the MTM program during 
      the HEDIS measurement year. MAIN OUTCOME MEASURES: Presence of low-density 
      lipoprotein cholesterol (LDL-C) screening, LDL-C values, and LDL-C control (<100 
      mg/dL). The use measure was the total number of 30-day medication equivalents. 
      Cost measures were (1) total Medicare Part D drug cost, (2) enrollees' 
      out-of-pocket Part D medication costs, and (3) total medication copayments. 
      Statistical analyses included chi-square, independent and paired t tests, and 
      analysis of variance with post hoc comparisons. RESULTS: Of 2, 114 enrollees 
      eligible for comprehensive diabetes care (CDC) according to HEDIS guidelines, 255 
      participated in the MTM intervention group and 56 patients were MTM eligible but 
      opted out of the program or could not be reached for medication review during 
      2008 (MTM nonparticipants). A higher proportion of patients in the MTM 
      participant group had LDL-C levels less than 100 mg/dL (69.0%) compared with 
      those in the MTM nonparticipant (50.0%) and CDC only (54.1%) groups (chi2 = 
      20.9(3), P < 0.001). The two control groups' average LDL-C (90.8 and 93.6 mg/dL) 
      was significantly higher than the intervention group (83.4 mg/dL, P < 0.001). 
      Overall, per member per month use and drug costs differed from 2007 to 2008 and 
      enrollees in the MTM participant group had greater percentage cost reductions. 
      CONCLUSION: Enrollees who were eligible for MTM services but did not receive them 
      had poorer clinical, use, and cost outcomes compared with the MTM intervention 
      group. Pharmacists collaborating with physicians through a MTM program can 
      improve quality of metrics for chronic diseases and reduce medication costs.
FAU - Fox, David
AU  - Fox D
AD  - Florida Health Care Plans, Holly Hill, USA.
FAU - Ried, L Douglas
AU  - Ried LD
FAU - Klein, Gary E
AU  - Klein GE
FAU - Myers, Wendy
AU  - Myers W
FAU - Foli, Kristen
AU  - Foli K
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Am Pharm Assoc (2003)
JT  - Journal of the American Pharmacists Association : JAPhA
JID - 101176252
RN  - 0 (Cholesterol, LDL)
SB  - IM
MH  - Aged
MH  - Cholesterol, LDL/*blood
MH  - Delivery of Health Care/*economics/statistics & numerical data
MH  - Diabetes Mellitus/blood/*drug therapy/economics
MH  - Drug Costs
MH  - Female
MH  - Florida
MH  - Humans
MH  - Male
MH  - Managed Care Programs/*economics/standards
MH  - Medicare Part D/economics
MH  - Medication Therapy Management/*economics/standards
MH  - *Quality Indicators, Health Care
MH  - United States
EDAT- 2009/03/18 09:00
MHDA- 2009/06/20 09:00
CRDT- 2009/03/18 09:00
PHST- 2009/03/18 09:00 [entrez]
PHST- 2009/03/18 09:00 [pubmed]
PHST- 2009/06/20 09:00 [medline]
AID - S1544-3191(15)30972-9 [pii]
AID - 10.1331/JAPhA.2009.09016 [doi]
PST - ppublish
SO  - J Am Pharm Assoc (2003). 2009 Mar-Apr;49(2):192-9. doi: 10.1331/JAPhA.2009.09016.